Targeted minute ventilation and tidal volume in an animal model of acute changes in lung mechanics and episodes of hypoxemia

Nelson R Claure, Cleide Suguihara, Jinghong Peng, Dorothy Hehre, Carmen D'Ugard, Eduardo Bancalari

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Acute episodes of hypoxemia in ventilated preterm infants are triggered by changes in ventilation, lung volume (LV) and respiratory system compliance (CRS) that are not prevented by conventional synchronized intermittent mandatory ventilation (SIMV). Objective: To assess in a rabbit model of episodic hypoxemia the individual and combined efficacy of targeted tidal volume (VT) and minute ventilation (V'E) by automatic adjustment of peak inspiratory pressure (PIP) and ventilator rate, respectively. Methods: Six young New Zealand white rabbits were ventilated with SIMV, targeted VT, targeted V'E, and combined targeted V'E + VT in random sequence. Hypoxemia episodes were induced by apnea alone or by apnea combined with a reduction in LV and C RS. Apnea was induced by a bolus of propofol. The reduction in LV and CRS was induced by chest compression with a cuff. PaO2 and PaCO2 were measured continuously by an indwelling arterial electrode. Results: During SIMV, apnea caused a decrease in ventilation and PaO2. This was attenuated during targeted V'E and targeted V'E + VT. Apnea plus a reduction in LV and CRS caused a greater decrease in ventilation and PaO2 during SIMV. These changes were attenuated during targeted VT and targeted V' E. The attenuation was more pronounced during targeted V'E + VT. Conclusion: In this animal model, targeted V'E was effective in reducing hypoxemia caused by apnea. When apnea was accompanied by a reduction in LV and CRS, the combined adjustment of PIP and ventilator rate was more effective than each individually. This combined strategy may be effective in ameliorating acute episodes of hypoxemia in preterm infants but this remains to be proven.

Original languageEnglish
Pages (from-to)132-140
Number of pages9
JournalNeonatology
Volume95
Issue number2
DOIs
StatePublished - Feb 1 2009

Fingerprint

Tidal Volume
Mechanics
Ventilation
Animal Models
Lung
Apnea
Pneumonectomy
Mechanical Ventilators
Hypoxia
Premature Infants
Rabbits
Pressure
Propofol
Respiratory System
Compliance
Electrodes
Thorax

Keywords

  • Preterm infant
  • Synchronized intermittent mandatory ventilation
  • Targeted ventilation

ASJC Scopus subject areas

  • Developmental Biology
  • Pediatrics, Perinatology, and Child Health

Cite this

Targeted minute ventilation and tidal volume in an animal model of acute changes in lung mechanics and episodes of hypoxemia. / Claure, Nelson R; Suguihara, Cleide; Peng, Jinghong; Hehre, Dorothy; D'Ugard, Carmen; Bancalari, Eduardo.

In: Neonatology, Vol. 95, No. 2, 01.02.2009, p. 132-140.

Research output: Contribution to journalArticle

Claure, Nelson R ; Suguihara, Cleide ; Peng, Jinghong ; Hehre, Dorothy ; D'Ugard, Carmen ; Bancalari, Eduardo. / Targeted minute ventilation and tidal volume in an animal model of acute changes in lung mechanics and episodes of hypoxemia. In: Neonatology. 2009 ; Vol. 95, No. 2. pp. 132-140.
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AU - D'Ugard, Carmen

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N2 - Background: Acute episodes of hypoxemia in ventilated preterm infants are triggered by changes in ventilation, lung volume (LV) and respiratory system compliance (CRS) that are not prevented by conventional synchronized intermittent mandatory ventilation (SIMV). Objective: To assess in a rabbit model of episodic hypoxemia the individual and combined efficacy of targeted tidal volume (VT) and minute ventilation (V'E) by automatic adjustment of peak inspiratory pressure (PIP) and ventilator rate, respectively. Methods: Six young New Zealand white rabbits were ventilated with SIMV, targeted VT, targeted V'E, and combined targeted V'E + VT in random sequence. Hypoxemia episodes were induced by apnea alone or by apnea combined with a reduction in LV and C RS. Apnea was induced by a bolus of propofol. The reduction in LV and CRS was induced by chest compression with a cuff. PaO2 and PaCO2 were measured continuously by an indwelling arterial electrode. Results: During SIMV, apnea caused a decrease in ventilation and PaO2. This was attenuated during targeted V'E and targeted V'E + VT. Apnea plus a reduction in LV and CRS caused a greater decrease in ventilation and PaO2 during SIMV. These changes were attenuated during targeted VT and targeted V' E. The attenuation was more pronounced during targeted V'E + VT. Conclusion: In this animal model, targeted V'E was effective in reducing hypoxemia caused by apnea. When apnea was accompanied by a reduction in LV and CRS, the combined adjustment of PIP and ventilator rate was more effective than each individually. This combined strategy may be effective in ameliorating acute episodes of hypoxemia in preterm infants but this remains to be proven.

AB - Background: Acute episodes of hypoxemia in ventilated preterm infants are triggered by changes in ventilation, lung volume (LV) and respiratory system compliance (CRS) that are not prevented by conventional synchronized intermittent mandatory ventilation (SIMV). Objective: To assess in a rabbit model of episodic hypoxemia the individual and combined efficacy of targeted tidal volume (VT) and minute ventilation (V'E) by automatic adjustment of peak inspiratory pressure (PIP) and ventilator rate, respectively. Methods: Six young New Zealand white rabbits were ventilated with SIMV, targeted VT, targeted V'E, and combined targeted V'E + VT in random sequence. Hypoxemia episodes were induced by apnea alone or by apnea combined with a reduction in LV and C RS. Apnea was induced by a bolus of propofol. The reduction in LV and CRS was induced by chest compression with a cuff. PaO2 and PaCO2 were measured continuously by an indwelling arterial electrode. Results: During SIMV, apnea caused a decrease in ventilation and PaO2. This was attenuated during targeted V'E and targeted V'E + VT. Apnea plus a reduction in LV and CRS caused a greater decrease in ventilation and PaO2 during SIMV. These changes were attenuated during targeted VT and targeted V' E. The attenuation was more pronounced during targeted V'E + VT. Conclusion: In this animal model, targeted V'E was effective in reducing hypoxemia caused by apnea. When apnea was accompanied by a reduction in LV and CRS, the combined adjustment of PIP and ventilator rate was more effective than each individually. This combined strategy may be effective in ameliorating acute episodes of hypoxemia in preterm infants but this remains to be proven.

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