Redistribution of Alveolar Pressure During Continuous Positive Pressure Ventilation with End Inspiratorg Pause

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• Changes in alveolar pressure were measured in the nondependent zone (NDZ) and dependent zone (DZ) during continuous positive pressure ventilation with end inspiratory pause (EIP). Eight anesthetized dogs were artificially ventilated (FIO2 1.0) on the right lateral position with a constant tidal volume of 20ml·kg-1 at a ventilatory rate of 15min-1 and end expiratory pressure of 5cm H2O. Inspiratory time (TI) and EIP were varied to produce a control pattern (TI 0.8sec+EIP 0sec), a slow inspiratory flow pattern (TI 2sec+EIP 0sec) and an EIP pattern (TI 0.8sec+EIP 1.2sec). Alveolar. pressures were measured in the left lower lobe (NDZ) and in the right upper lobe (DZ) through capsules glued to each pleural surface. The intracapsular space had adequate communication with alveoli via holes of pleural punctures as was confirmed by histological study of the capsule site. End inspiratory alveolar pressure significantly increased in DZ with a slow inspiratory flow pattern. End inspiratory pressures significantly decreased in NDZ and increased in DZ in the EIP pattern. This means there is a declined alveolar pressure gradient between NDZ and DZ. Alveolar pressures significantly decreased in NDZ and increased in DZ at the end of EIP compared to those at the beginning of EIP. The EIP pressure patterns showed a gradual decreasing wave in NDZ and a gradual increasing wave in DZ. Alveolar pressures were higher in NDZ and lower in DZ at the initial inspiratory phase. Pressure distribution became more homogeneous when EIP was applied as redistribution of alveolar pressure occured from NDZ to DZ.

• 一般社団法人 日本集中治療医学会の論文

一般社団法人 日本集中治療医学会 | 論文

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