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Authordc.contributor.authorAraos, Joaquín
Authordc.contributor.authorAlegría, Leyla
Authordc.contributor.authorGarcía, Aline
Authordc.contributor.authorCruces, Pablo
Authordc.contributor.authorSoto, Dagoberto
Authordc.contributor.authorErranz, Benjamín
Authordc.contributor.authorSalomón, Tatiana
Authordc.contributor.authorMedina, Tania
Authordc.contributor.authorGarcía, Patricio
Authordc.contributor.authorDubo, Sebastián
Authordc.contributor.authorBachmann, Maria C.
Authordc.contributor.authorBasoalto, Roque
Authordc.contributor.authorValenzuela, Emilio D.
Authordc.contributor.authorRovegno, Maximiliano
Authordc.contributor.authorVera, Magdalena
Authordc.contributor.authorRetamal, Jaime
Authordc.contributor.authorCornejo Rosas, Rodrigo Alfredo
Authordc.contributor.authorBugedo, Guillermo
Authordc.contributor.authorBruhn, Alejandro
Admission datedc.date.accessioned2022-03-03T22:12:31Z
Available datedc.date.available2022-03-03T22:12:31Z
Publication datedc.date.issued2021
Cita de ítemdc.identifier.citationBritish Journal of Anaesthesia, 127 (5): 807e814 (2021)es_ES
Identifierdc.identifier.other10.1016/j.bja.2021.07.031
Identifierdc.identifier.urihttps://repositorio.uchile.cl/handle/2250/184044
Abstractdc.description.abstractBackground: Lung rest has been recommended during extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS). Whether positive end-expiratory pressure (PEEP) confers lung protection during ECMO for severe ARDS is unclear. We compared the effects of three different PEEP levels whilst applying near-apnoeic ventilation in a model of severe ARDS treated with ECMO. Methods: Acute respiratory distress syndrome was induced in anaesthetised adult male pigs by repeated saline lavage and injurious ventilation for 1.5 h. After ECMO was commenced, the pigs received standardised near-apnoeic ventilation for 24 h to maintain similar driving pressures and were randomly assigned to PEEP of 0, 10, or 20 cm H2O (n=7 per group). Respiratory and haemodynamic data were collected throughout the study. Histological injury was assessed by a pathologist masked to PEEP allocation. Lung oedema was estimated by wet-to-dry-weight ratio. Results: All pigs developed severe ARDS. Oxygenation on ECMO improved with PEEP of 10 or 20 cm H2O, but did not in pigs allocated to PEEP of 0 cm H2O. Haemodynamic collapse refractory to norepinephrine (n=4) and early death (n=3) occurred after PEEP 20 cm H2O. The severity of lung injury was lowest after PEEP of 10 cm H2O in both dependent and non-dependent lung regions, compared with PEEP of 0 or 20 cm H2O. A higher wet-to-dry-weight ratio, indicating worse lung injury, was observed with PEEP of 0 cm H2O. Histological assessment suggested that lung injury was minimised with PEEP of 10 cm H2O. Conclusions: During near-apnoeic ventilation and ECMO in experimental severe ARDS, 10 cm H2O PEEP minimised lung injury and improved gas exchange without compromising haemodynamic stability.es_ES
Patrocinadordc.description.sponsorshipComision Nacional de Investigacion Cientifica y Tecnologica (Fondo Nacional de Desarrollo Cientifico y Tecnologico) 1130248 1161556 Comision Nacional de Investigacion Cientifica y Tecnologica/Doctorado Nacional/2013es_ES
Lenguagedc.language.isoenes_ES
Publisherdc.publisherElsevieres_ES
Type of licensedc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
Link to Licensedc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
Sourcedc.sourceBritish Journal of Anaesthesiaes_ES
Keywordsdc.subjectAcute respiratory distress syndromees_ES
Keywordsdc.subjectExtracorporeal membrane oxygenationes_ES
Keywordsdc.subjectMechanical ventilationes_ES
Keywordsdc.subjectPositive end-expiratory pressurees_ES
Keywordsdc.subjectVentilator-induced lung injuryes_ES
Títulodc.titleEffect of positive end-expiratory pressure on lung injury and haemodynamics during experimental acute respiratory distress syndrome treated with extracorporeal membrane oxygenation and near-apnoeic ventilationes_ES
Document typedc.typeArtículo de revistaes_ES
dc.description.versiondc.description.versionVersión publicada - versión final del editores_ES
dcterms.accessRightsdcterms.accessRightsAcceso abiertoes_ES
Catalogueruchile.catalogadorcrbes_ES
Indexationuchile.indexArtículo de publícación WoSes_ES


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Attribution-NonCommercial-NoDerivs 3.0 United States
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivs 3.0 United States