Effekte der Kombination aus Hochfrequenzoszillation und arteriovenöser extrakorporaler Lungenassistenz auf die Histopathologie und die Zytokinexpression im 24 Stunden Großtier-ARDS-Modell
High-frequency oscillation combined with arteriovenous extracorporeal lung assist reduces lung injury
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- Die Hochfrequenzoszillation (HFOV; Frequenz 12-15 Hz) reduziert in Kombination mit einer ECLA die beatmungsinduzierte Lungenschädigung und das Lungenbiotrauma im Vergleich zur konventionellen lungenprotektiven Beatmung (PCV) mit niedrigen Tidalvolumina (6 ml/kg KG) Die HFOV hat in Kombination mit ECLA keine negativen Auswirkungen auf den Gasaustausch und die Hämodynamik
- In order to optimize the lung-protective potential of high-frequency oscillatory ventilation (HFOV), it is currently recommended to maximize oscillatory frequencies. However, very high frequencies may lead to insufficient CO(2) elimination with severe respiratory acidosis. Arteriovenous extracorporeal lung assist (av-ECLA) allows near total CO(2) removal, thereby allowing for maximization of the lung-protective potential of HFOV. The aim of this study was to determine the impact of HFOV and av-ECLA on lung inflammation and function compared toIn order to optimize the lung-protective potential of high-frequency oscillatory ventilation (HFOV), it is currently recommended to maximize oscillatory frequencies. However, very high frequencies may lead to insufficient CO(2) elimination with severe respiratory acidosis. Arteriovenous extracorporeal lung assist (av-ECLA) allows near total CO(2) removal, thereby allowing for maximization of the lung-protective potential of HFOV. The aim of this study was to determine the impact of HFOV and av-ECLA on lung inflammation and function compared to conventional lung-protective ventilation. In a porcine surfactant depletion model of lung injury, the authors randomly assigned 16 female pigs to conventional lung-protective ventilation and HFOV/ECLA. Both strategies were combined with an "open-lung" approach. Gas exchange and hemodynamic parameters were measured at intervals during the 24-hour study period. Postmortem, lung tissue was analyzed to determine histological damage and lung inflammation. The authors found that the combination of HFOV and av-ECLA (1) allows significant reductions in mean and peak airway pressures; and (2) reduces histological signs of lung inflammation in the basal regions of the lung. HFOV/av-ECLA reduces histological signs of lung inflammation compared to conventional lung-protective ventilation strategies. Thus, combination of HFOV and av-ECLA might be a further lung-protective tool if conventional ventilation strategies are failing.…
Autor(en): | Gregor Johannes Siebenlist |
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URN: | urn:nbn:de:bvb:20-opus-52659 |
Dokumentart: | Dissertation |
Titelverleihende Fakultät: | Universität Würzburg, Medizinische Fakultät |
Institute der Universität: | Medizinische Fakultät / Klinik und Poliklinik für Anästhesiologie (ab 2004) |
Datum der Abschlussprüfung: | 22.11.2010 |
Sprache der Veröffentlichung: | Deutsch |
Erscheinungsjahr: | 2010 |
Allgemeine fachliche Zuordnung (DDC-Klassifikation): | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Normierte Schlagworte (GND): | ARDS |
Freie Schlagwort(e): | ECLA; HFOV ECLA; HFOV |
Datum der Freischaltung: | 24.11.2010 |
Betreuer: | Prof. Dr. Norbert Roewer |
Lizenz (Deutsch): | Deutsches Urheberrecht |