Influence of fluid and volume state on PaO(2) oscillations in mechanically ventilated pigs

Bodenstein, Marc; Bierschock, Stephan; Boehme, Stefan; Wang, Hemei; Vogt, Andreas; Kwiecien, Robert; David, Matthias; Markstaller, Klaus (2013). Influence of fluid and volume state on PaO(2) oscillations in mechanically ventilated pigs. Experimental lung research, 39(2), pp. 80-90. New York, N.Y.: Informa Healthcare 10.3109/01902148.2012.758192

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ABSTRACT Varying pulmonary shunt fractions during the respiratory cycle cause oxygen oscillations during mechanical ventilation. In artificially damaged lungs, cyclical recruitment of atelectasis is responsible for varying shunt according to published evidence. We introduce a complimentary hypothesis that cyclically varying shunt in healthy lungs is caused by cyclical redistribution of pulmonary perfusion. Administration of crystalloid or colloid infusions would decrease oxygen oscillations if our hypothesis was right. Therefore, n = 14 mechanically ventilated healthy pigs were investigated in 2 groups: crystalloid (fluid) versus no-fluid administration. Additional volume interventions (colloid infusion, blood withdrawal) were carried out in each pig. Intra-aortal PaO(2) oscillations were recorded using fluorescence quenching technique. Phase shift of oxygen oscillations during altered inspiratory to expiratory (I:E) ventilation ratio and electrical impedance tomography (EIT) served as control methods to exclude that recruitment of atelectasis is responsible for oxygen oscillations. In hypovolemia relevant oxygen oscillations could be recorded. Fluid and volume state changed PaO(2) oscillations according to our hypothesis. Fluid administration led to a mean decline of 105.3 mmHg of the PaO(2) oscillations amplitude (P < 0.001). The difference of the amplitudes between colloid administration and blood withdrawal was 62.4 mmHg in pigs not having received fluids (P = 0.0059). Fluid and volume state also changed the oscillation phase during altered I:E ratio. EIT excluded changes of regional ventilation (i.e., recruitment of atelectasis) to be responsible for these oscillations. In healthy pigs, cyclical redistribution of pulmonary perfusion can explain the size of respiratory-dependent PaO(2) oscillations.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
UniBE Contributor:	Vogt, Andreas
ISSN:	0190-2148
Publisher:	Informa Healthcare
Language:	English
Submitter:	Jeannie Wurz
Date Deposited:	04 Oct 2013 14:33
Last Modified:	05 Dec 2022 14:10
Publisher DOI:	10.3109/01902148.2012.758192
PubMed ID:	23320977
Web of Science ID:	000314943700003
URI:	https://boris.unibe.ch/id/eprint/13017 (FactScience: 219518)