Hypercapnic acidosis is protective in an in vivo model of ventilator-induced lung injury

Scott Sinclair, David A. Kregenow, Wayne J.E. Lamm, Ian R. Starr, Emil Y. Chi, Michael P. Hlastala

Research output: Contribution to journalArticle

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Abstract

To investigate whether hypercapnic acidosis protects against ventilator-induced lung injury (VILI) in vivo, we subjected 12 anesthetized, paralyzed rabbits to high tidal volume ventilation (25 cc/kg) at 32 breaths per minute and zero positive end-expiratory pressure for 4 hours. Each rabbit was randomized to receive either an FI CO2 to achieve eucapnia (Pa CO2 ∼ 40 mm Hg; n = 6) or hypercapnic acidosis (Pa CO2 80-100 mm Hg; n = 6). Injury was assessed by measuring differences between the two groups' respiratory mechanics, gas exchange, wet:dry weight, bronchoalveolar lavage fluid protein concentration and cell count, and injury score. The eucapnic group showed significantly higher plateau pressures (27.0 ± 2.5 versus 20.9 ± 3.0; p = 0.016), change in Pa O2 (165.2 ± 19.4 versus 77.3 ± 87.9 mm Hg; p = 0.02), wet:dry weight (9.7 ± 2.3 versus 6.6 ± 1.8; p = 0.04), bronchoalveolar lavage protein concentration (1,350 ± 228 versus 656 ± 511 μg/ml; p = 0.03), cell count (6.86 × 10 5 ± 0.18 ± 10 5 versus 2.84 × 10 5 ± 0.28 × 10 5 nucleated cells/ml; p = 0.021), and injury score (7.0 ± 3.3 versus 0.7 ± 0.9; p < 0.0001). We conclude that hypercapnic acidosis is protective against VILI in this model.

Original languageEnglish (US)
Pages (from-to)403-408
Number of pages6
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume166
Issue number3
DOIs
StatePublished - Aug 1 2002
Externally publishedYes

Fingerprint

Ventilator-Induced Lung Injury
Acidosis
Wounds and Injuries
Cell Count
Rabbits
Respiratory Mechanics
Weights and Measures
Positive-Pressure Respiration
Tidal Volume
Bronchoalveolar Lavage Fluid
Bronchoalveolar Lavage
Proteins
Gases
Pressure

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Hypercapnic acidosis is protective in an in vivo model of ventilator-induced lung injury. / Sinclair, Scott; Kregenow, David A.; Lamm, Wayne J.E.; Starr, Ian R.; Chi, Emil Y.; Hlastala, Michael P.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 166, No. 3, 01.08.2002, p. 403-408.

Research output: Contribution to journalArticle

Sinclair, Scott ; Kregenow, David A. ; Lamm, Wayne J.E. ; Starr, Ian R. ; Chi, Emil Y. ; Hlastala, Michael P. / Hypercapnic acidosis is protective in an in vivo model of ventilator-induced lung injury. In: American Journal of Respiratory and Critical Care Medicine. 2002 ; Vol. 166, No. 3. pp. 403-408.
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