Mechanical ventilation is an important support for patients with acute respiratory distress syndrome (ARDS), although it can cause ventilator-induced lung injury (VILI) [1-3]. The key to a successful clinical management of patients with ARDS is avoidance of further advancement of VILI [1-3]. For this reason, prevention of alveolar overdistension and derecruitment are the goals of recently proposed lung protective ventilation strategies. In order to achieve optimal alveolar recruitment, patients with ARDS are often exposed to high levels of positive end expiratory pressure (PEEP) [3-5]. During disconnect from ventilator, patients may be exposed to unintended sudden withdrawal of PEEP, which may induce harm to ARDS patients by causing lung collapse (derecuritment) and hypoxia.
After lung injury, intermittent mandatory pressure control ventilation was set up. The fraction of inspired oxygen was set at 1.0. Tidal volume was set at 6 mL/kg, inspiratory time at 0.5 secs, PEEP set at 10 cm H2O and the mandatory respiratory rate at 30/min. The mandatory respiratory rate was subsequently adjusted to maintain the PaCO2 in the range of 60-100 mmHg when possible, with a minimum rate of 4 /min and maximum of 40/min.
Effects of Closed Vs. Open Repeated Endotracheal Suctioning During Mechanical Ventilation on the Pulmonary and Circulatory Levels of Endothelin-1 in Lavage-Induced Rabbit ARDS Model: Hideaki Sakuramoto, Subrina Jesmin, Nobutake Shimojo, Junko Kamiyama, Ken Miya, Majedul Islam, Tanzila Khatun, Satoru Kawano and Taro Mizutani
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Last date updated on June, 2014