Article Text

RENOPULMONARY INTERACTION DURING MECHANICAL VENTILATION OF HEALTHY LUNGS: AN EXPERIMENTAL STUDY
  1. J Fremuth1,
  2. J Kobr1,
  3. K Pizingerova1,
  4. L Sasek1,
  5. S Fikrlova1,
  6. P Jehlicka1,
  7. P Honomichl1,
  8. J Racek2
  1. 1Department of Pediatrics, Faculty Hospital in Pilsen, Pilsen, Czech Republic
  2. 2Department of Biochemistry, Faculty Hospital in Pilsen, Pilsen, Czech Republic

Abstract

Objective To prove the existence of renopulmonary interaction during mechanical ventilation and to identify the affecting factors.

Design Experimental, closed, randomized, comparative.

Material and Methods The study included a total of 15 healthy domestic piglets. Group A – spontaneously breathing piglets. Group B – piglets ventilated for 12 hours, VT 6 ml/kg. Group C – piglets ventilated for 12 hours, VT 10 ml/kg. Clinical monitoring and laboratory tests were recorded 1 hour after beginning of this experiment and after 12 hours (groups B and C). Mechanical ventilation was assessed by lung mechanics and ventilatory indexes, cardiovascular system by measurement of systemic pressure and echocardiography. The renal function was assessed by one-hour diuresis, laboratory tests, glomerular filtration, free water clearance and fractional excretion of sodium. The obtained data were statistically analyzed. Values of p<0.05 were considered statistically significant.

Results After 1 hour of mechanical ventilation the following parameters were decreased in both groups: global function of right ventricle (p<0.05), glomerular filtration (p<0.020), free water clearance (p<0.018) and fractional excretion of sodium (p<0.005). The decrease of the above parameters after 12 hours of mechanical ventilation was even more significant in group C (p<0.03). Left ventricle performance, systemic arterial pressure and one-hour diuresis were not influenced in the course of this study.

Conclusion Mechanical ventilation induces renopulmonary interaction. Tidal volume of 10 ml/kg and time influence systemic as well as regional hemodynamics and contribute to the decrease of glomerular filtration, sodium and fluid retention.

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