artículo de publicación periódica.page.titleprefix
Effect of PEEP on dead space in an experimental model of ARDS

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dc.contributor.authorTusman, Gerardo
dc.contributor.authorGogniat, Emiliano
dc.contributor.authorMadorno, Matías
dc.contributor.authorOtero, Pablo
dc.contributor.authorDianti, José
dc.contributor.authorFernández Ceballos, Ignacio
dc.contributor.authorCeballos, Martín
dc.contributor.authorVerdier, Natalí
dc.contributor.authorBöhm, Stephan H.
dc.contributor.authorRodríguez, Pablo Oscar
dc.contributor.authorSan Román, Eduardo
dc.date.accessioned2020-12-17T20:08:43Z
dc.date.available2020-12-17T20:08:43Z
dc.date.issued2020
dc.description.abstract"Background: Difference between Bohr and Enghoff dead space are not well described in ARDS patients. We aimed to analyze the effect of PEEP on the Bohr and Enghoff dead spaces in a model of ARDS. Methods: 10 pigs submitted to randomized PEEP steps of 0, 5, 10, 15, 20, 25 and 30 cm H2O were evaluated with the use of lung ultrasound images, alveolar-arterial oxygen difference (P(A-a)O2), transpulmonary mechanics, and volumetric capnography at each PEEP step. Results: At PEEP > 15 cm H2O, atelectasis and P(A-a)O2 progressively decreased while endinspiratory transpulmonary pressure (PL), end-expiratory PL, and driving PL increased (all P < .001). Bohr dead space (VDBohr/VT), airway dead space (VDaw/VT), and alveolar dead space (VDalv/VTalv) reached their highest values at PEEP 30 cm H2O (0.69 0.10, 0.53 0.13 and 0.35 0.06, respectively). At PEEP <15 cm H2O, the increases in atelectasis and P(A-a)O2 were associated with negative end-expiratory PL and highest driving PL. VDBohr/VT and VDaw/VT showed the lowest values at PEEP 0 cm H2O (0.51 0.08 and 0.32 0.08, respectively), whereas VDalv/VTalv increased to 0.27 0.05. Enghoff dead space and its derived VDalv/VTalv showed high values at low PEEPs (0.86 0.02 and 0.79 0.04, respectively) and at high PEEPs (0.84 0.04 and 0.65 0.12), with the lowest values at 15 cm H2O (0.77 0.05 and 0.61 0.11, respectively; all P < .001). CONCLUSIONS: Bohr dead space was associated to lung stress, whereas Enghoff dead space was partially affected by the shunt effect. Key words: dead space; PEEP; lung stress; ARDS; VILI; carbon dioxide."en
dc.identifier.issn0020-1324
dc.identifier.urihttp://ri.itba.edu.ar/handle/123456789/3262
dc.language.isoeses
dc.relationinfo:eu-repo/semantics/altIdentifier/doi/10.4187/respcare.06843
dc.rightsinfo:eu-repo/semantics/embargoedAccess/2021-12-17
dc.subjectCAPNOGRAFIAes
dc.subjectSINDROME DE DIFICULTAD RESPIRATORIA DEL ADULTOes
dc.subjectDIOXIDO DE CARBONOes
dc.titleEffect of PEEP on dead space in an experimental model of ARDSen
dc.typeArtículos de Publicaciones Periódicases
dc.typeinfo:eu-repo/semantics/acceptedVersion
dspace.entity.typeArtículo de Publicación Periódica
itba.description.filiationFil: Tusman, Gerardo. Hospital Privado de Comunidad; Argentina.
itba.description.filiationFil: Gogniat, Emiliano. Hospital Italiano de Buenos Aires; Argentina.
itba.description.filiationFil: Madorno, Matías. Instituto Tecnológico de Buenos Aires; Argentina.
itba.description.filiationFil: Otero, Pablo. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; Argentina.
itba.description.filiationFil: Dianti, José. Hospital Italiano de Buenos Aires; Argentina.
itba.description.filiationFil: Fernández Ceballos, Ignacio. Hospital Italiano de Buenos Aires; Argentina.
itba.description.filiationFil: Ceballos, Martín. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; Argentina.
itba.description.filiationFil: Verdier, Natalí. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias; Argentina.
itba.description.filiationFil: Böhm, Stephan H. Universitätsmedizin Rostock; Alemania.
itba.description.filiationFil: Rodríguez, Pablo Oscar. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”; Argentina.
itba.description.filiationFil: San Román, Eduardo. Hospital Italiano de Buenos Aires; Argentina.

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