Abstract

Using animal models, we have shown that mechanical pulmonary ventilation as now practiced can under certain conditions become highly injurious, and lethal (adult respiratory distress syndrome = ARDS). This injury process is related to peak inspiratory pressures, and duration of mechanical pulmonary ventilation. Using such an animal model of ARDS we have managed sheep on extracorporeal veno-venous blood gas exchange, while discontinuing all mechanical pulmonary ventilation. Within 24 hours of change in treatment to extracorporeal blood gas exchange, there was rapid improvement in pulmonary function in all animals, and 9/11 sheep were weaned off bypass and to room air. In a control group of animals treated with conventional continuous positive pressure ventilation (CPP) only 3/11 sheep could be weaned off bypass. This animal model of ARDS can become sufficiently severe so that no form of presently available therapy will lead to survivors. Such understanding only emphasizes the as yet unrecognized dangers implied in the use of CPPV.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Intramural Research (Z01)
Project #
1Z01HL001404-20
Application #
3942818
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
20
Fiscal Year
1987
Total Cost
Indirect Cost

  Institution

Name
U.S. National Heart Lung and Blood Inst
Department
Type
DUNS #
City
State
Country
United States
Zip Code

  Publications

Rezoagli, Emanuele; Zanella, Alberto; Cressoni, Massimo et al. (2017) Pathogenic Link Between Postextubation Pneumonia and Ventilator-Associated Pneumonia: An Experimental Study. Anesth Analg 124:1339-1346
Li Bassi, Gianluigi; Berra, Lorenzo; Kolobow, Theodor (2007) Silver-coated endotracheal tubes: is the bactericidal effect time limited? Crit Care Med 35:986;author reply 987
Parravicini, Elvira; Baccarelli, Andrea; Wung, Jen Tien et al. (2007) A comparison of a new, ultrathin-walled two-stage twin endotracheal tube and a conventional endotracheal tube in very premature infants with respiratory distress syndrome: a pilot study. Am J Perinatol 24:117-22
Li Bassi, Gianluigi; Curto, Francesco; Zanella, Alberto et al. (2007) A 72-hour study to test the efficacy and safety of the ""Mucus Slurper"" in mechanically ventilated sheep. Crit Care Med 35:906-11
Kolobow, Theodor; Berra, Lorenzo; Li Bassi, Gianluigi et al. (2005) Novel system for complete removal of secretions within the endotracheal tube: the Mucus Shaver. Anesthesiology 102:1063-5
Berra, Lorenzo; De Marchi, Lorenzo; Panigada, Mauro et al. (2004) Evaluation of continuous aspiration of subglottic secretion in an in vivo study. Crit Care Med 32:2071-8
Kolobow, Theodor (2004) The artificial lung: the past. A personal retrospective. ASAIO J 50:xliii-xlviii
Kolobow, Theodor; Berra, Lorenzo; DeMarchi, Lorenzo et al. (2004) Ultrathin-wall, two-stage, twin endotracheal tube: a tracheal tube with minimal resistance and minimal dead space for use in newborn and infant patients. Pediatr Crit Care Med 5:379-83
Berra, Lorenzo; De Marchi, Lorenzo; Yu, Zu-Xi et al. (2004) Endotracheal tubes coated with antiseptics decrease bacterial colonization of the ventilator circuits, lungs, and endotracheal tube. Anesthesiology 100:1446-56
Kolobow, Theodor (2004) Volutrauma, barotrauma, and ventilator-induced lung injury: lessons learned from the animal research laboratory. Crit Care Med 32:1961-2

Showing the most recent 10 out of 15 publications