Efecto de tres modos ventilatorios como único soporte en un modelo experimental de inflamación sistémica por lipopolisacárido sobre la hemodinamia, fisiología pulmonar e histología

Abstract

. Introduction: The airway pressure release ventilation (APRV) and high frequency oscillatory ventilation (HFOV) modes provides lung protection, but is not used in patients with sepsis. Objective: Compared the effect of mechanical ventilation support (MVS) in PCV, APRV and HFOV modes as the only therapy in a pig model of systemic inflammation induced by Escherichia coli lipopolysaccharide on hemodynamics, gasometry, mechanics and lung histology. Material and methods: Eighteen pigs with systemic inflammation were treated only with MVS: group I: PCV, group II: APRV and group III: HFOV. gasometric values, mechanics and histology assessed for six hours. Results: The three ventilatory modes alter pulmonary hemodynamics, but maintain gasometry and lung mechanics values. The HFOV remain stable systemic hemodynamic values, hyperlactatemia (p < 0.05, ANOVA‑MR) and produces less histological damage (p < 0.05, Kruskal‑Wallis). Conclusions: The APRV and HFOV modes used as the unique support in the initial phases of sepsis induced with LPS of Escherichia coli in pigs, maintain the gasometric and ventilatory values within normal parameters; but, the HFOV mode favors the recovery of systemic hemodynamic values and produces less histological damage.