Aspiration pneumonia: beneficial and harmful effects of positive end expiratory pressure

T. Toung, P. Saharia, S. Permutt, G. D. Zuidema, J. L. Cameron

Research output: Contribution to journalArticlepeer-review

Abstract

With an ex vivo, isolated, perfused canine pulmonary lobe, the effects of various levels of positive end-expiratory pressure (PEEP) were evaluated following acid injury. Following intrabronchial instillation of hydrochloric acid, eight lobes were ventilated with 5 cm of H 2O of PEEP, 12 lobes with 10 cm of PEEP, and eight lobes with 15 cm of PEEP during a 4 hour perfusion period. Blood flow was kept constant in all preparations. Lobes with 5 cm of PEEP developed a 39% intrapulmonary shunt and increased their weight by 220%. When PEEP was increased to 10 cm, weight gain was similar (184%), but shunting decreased markedly, to 7%. When PEEP was increased further to 15 cm, shunting remained low (13%), but weight gain increased markedly, to 411% of the initial lobe weight. This study demonstrates the beneficial effects of PEEP in aspiration pneumonia, but it also points out that the increasing levels of PEEP can magnify acid-pulmonary injury by causing a further increase in interstitial and intralveolar edema.

Original languageEnglish (US)
Pages (from-to)279-283
Number of pages5
JournalSurgery
Volume82
Issue number2
StatePublished - Dec 1 1977

ASJC Scopus subject areas

  • Surgery

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