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Effect of three ventilation modes as the only support in a pig model with LPS-induced systemic inflammation on pulmonary physiology, histology and hemodynamics

Guzmán-Cedillo, Axel E; Olmos-Zúñiga, J Raúl; Jasso-Victoria, Rogelio; García-Torrentera, Rogelio; Gaxiola-Gaxiola, Miguel; Silva-Martínez, Mariana; Vázquez-Justiniano, Luis Florentino; Baltazares-Lipp, Matilde; Hernández-Jiménez, Claudia; Zenteno-Galindo, Edgar; Vadillo-Ortega, Felipe; González-Camarena, Ramón





2020, Number 1

2020; 79 (1)






ABSTRACT

Introduction: The airway pressure release ventilation (APRV) and high frequency oscillatory ventilation (HFOV) modes provides lung protection, but is not used in patients with sepsis. Objective: Compared the effect of mechanical ventilation support (MVS) in PCV, APRV and HFOV modes as the only therapy in a pig model of systemic inflammation induced by Escherichia coli lipopolysaccharide on hemodynamics, gasometry, mechanics and lung histology. Material and methods: Eighteen pigs with systemic inflammation were treated only with MVS: group I: PCV, group II: APRV and group III: HFOV. Hemodynamic parameters, gasometric values, lung mechanics and histology were assessed for six hours. Results: The three ventilatory modes alter pulmonary hemodynamics, but maintain gasometry and lung mechanics values. The HFOV remain stable systemic hemodynamic values, decreases hyperlactatemia (p ‹ 0.05, ANOVA-MR) and produces less histological damage (p ‹ 0.05, Kruskal-Wallis). Conclusions: The PCV, APRV and HFOV modes used as the unique support in the initial phases of sepsis induced with LPS of Escherichia coli in pigs, maintain the gasometric and ventilatory values within normal parameters; but, the HFOV mode favors the recovery of systemic hemodynamic values and produces less histological damage.

KEYWORDS

Systemic inflammation, lipopolysaccharide, mechanical ventilation support, airway pressure release ventilation, high frequency oscillatory ventilation.

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2020, Number 1

2020; 79 (1)