급성 폐손상의 기계환기 치료에서 일회호흡량 변화가 미치는 영향 : 실험 연구 = Effects of Tidal Volume Changes in Mechanical Ventilation Mansgement for Acute Lung Injury An Experimental Study

다국어 초록 (Multilingual Abstract)

Background: Although the low tidal volume(TV) technique has been applied in the manage- ment of mechanical ventilation for patients with Acute Respiratory Distress Syndrome(ARDS) recently, there still remain controversies with regards to its effectiveness and hazard.
Method: The study was designed to evaluate the effects of the amount of TV on hemody- namics, arterial blood gases, and airway pressures in an acute lung injury model by using six mongrel dogs. Each animal was paralyzed and intubated with applying mechanical ventilation at TV of 10mUkg, respiration rate of 20/min, FiO₂of 0.4, and Positive End Expiratory Pressure (PEEP) of 5cmH₂O. The lung injury was induced by injection of oleic acid dissolved in 99% ethanol(0.08ml/kg) into the pulmonary artery through a Swan-Ganz catheter. Parameters were observed with changes of TV to low(7ml/kg) and high(14ml/kg) accordingly, and the differ- ences between groups were compared statistically. Result: There were significant differences in airway pressure(16.5 ±2 vs. 23.3 ±3.4cmH₂O) and PaCO₂(54 ±12 vs. 42.8 ±9mmHg) between low and high TV(p$lt;0.01) while the differences in PaO₂(100.9 ±17 vs. 121.2 ±16mmHg) and mean Blood Pressure(BP)(96.0 ±12 vs. 106 ±19mmHg) were negligible(p=NS). Conclusion : Above results suggest that low TV keeps airway pressure low and does not deteriorate hemodynamics and oxygenation in the presence of hypezcapnia. We carefully sug- gest a low TV technique in the management of the patients with ARDS.