Effects of ventilatory pattern on experimental lung injury caused by high airway pressure

Dana A. Simonson, Alexander B. Adams, Laurel A. Wright, David J. Dries, John R. Hotchkiss, John J. Marini

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Objective: To determine the influence of clinician-adjustable ventilator settings on the development of ventilator-Induced lung injury, as assessed by changes in gas exchange (Pao 2), compliance, functional residual capacity, and wet weight to dry weight ratio. Design: Randomized in vivo rabbit study. Setting: Hospital research laboratory. Subjects: Forty-four anesthetized, mechanically ventilated adult rabbits. Interventions: Ventilation for 2 hrs with pressure control ventilation at 45 cm H 2O, Flo 2 - 0.6, and randomization to one of five ventilatory strategies using combinations of positive end-expiratory pressure (3 or 12 cm H 2O), inspiratory time (0.45, 1.0, or 2.0 secs), and frequency (9 or 23/min). Measurements and Main Results: Among the ventilator strategies applied, PEEP at 12 cm H 2O (elevated positive end-expiratory pressure) and inspiratory time at 0.45 secs (reduced inspiratory time) best preserved Pao 2 (p < .003) and compliance (p < .035). During Injury development, two consistent changes were observed: Tidal volume increased, and airway pressure waveform was transformed by extending the time to attain target pressure. Conclusions: In this preclinical model, lung injury was attenuated by decreasing inspiratory time. As lung injury occurred, tidal volume increased and airway pressure waveform changed.

Original languageEnglish (US)
Pages (from-to)781-786
Number of pages6
JournalCritical care medicine
Issue number3
StatePublished - Mar 2004


  • Animal model
  • Barotrauma
  • Mechanical
  • Positive end-expiratory pressure
  • Ventilation
  • Ventilator strategy
  • Ventilator-induced lung injury


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