Die Beatmung mit niedrigen Tidal-Volumina verbessert die zerebrale Gewebeoxygenierung im experimentellen Tiermodell des akuten Lungenversagens

Abstract

OBJECTIVE: To investigate the effects of different tidal volumes on cerebral tissue oxygenation. DESIGN: Prospective, controlled animal study.SETTING: Animal research facility of a university hospital.INTERVENTIONS: Two conditions were studied in fourteen female pigs with experimental acute lung injury (ALI) induced by surfactant depletion: 1) low tidal volume ventilation (LT) with 6 ml/kg body weight, 2) high tidal volume ventilation (HT) with 12 ml/kg body weight. For each condition, gas exchange, haemodynamics and continuous cerebral tissue oxygen tension (ptiO2) were analyzed. After induction of ALI, data was collected at 2, 4 and 8 h.MEASUREMENTS AND RESULTS: At baseline, no differences between the groups were found. After induction of ALI, ptiO2 showed a trend towards decreased oxygenation in the HT-group (1.9 ± 3.1 mmHg vs. 8.1 ± 8.7 mmHg, NS). 2, 4 and 8 h after induction of ALI, ptiO2 was significantly lower in the HT-group. paO2 showed no significant differences between the groups at all time points.CONCLUSION: Protective ventilation with low tidal volumes yielded a significant improvement in cerebral tissue oxygenation compared to high tidal volume ventilation. There was dissociation between arterial and cerebral tissue oxygenation