Effect Of High Frequency Oscillatory Ventilation On EVLW And Lung Capillary Permeability Of Acute Respiratory Distress Syndrome Caused By Pulmonary And Extrapulmonary Insults

Objective Try to establish a stable lung endogenous and exogenous acute respiratory distress syndrome model in piglets, looking for ways to build PiCCO monitoring for young pigs, then try to evaluate the effectiveness of HFOV on EVLW and lung capillary permeability in piglets with pulmonary or extrapulmonary ARDS.Methods Twelve anesthetized and intubated piglets prepare with CVP and PiCCO catheters for monitoring were randomly allocated to two experimental groups, ARDSp and ARDSexp. Models were respectively reproduced by saline solution lung lavage and oleic acid injection intravenously. Then HFOV for4hours were introduced. The variables, EVLWI and EVLW/ITBV and PVPI,were obtained before and after modeled(T0and T1),and after HFOV was given at T2(lh),T3(2h),T4(3h) and T5(4h) treatment timepoints.Results At T1,T3,T4and T5timepoints, EVLWI increased more in ARDSp than ARDSexp(P<0.05);The EVLWI in ARDSp had increased at T1(P=0.008),and the values sustained continuously within2hours (P=0.679, P=0.216), but decreased at T4(P=0.007) and T5(P=0.037). The EVLWI in ARDSexp also increased at T1(P=0.003),but a significant decrease was found at T3(P=0.002) and T4(P=0.019). PVPI was both found increase after models were maded (P=0.004, P=0.012). However, there were no significance variability within4hours under HFOV in ARDSp, while PVPI appeared the increasing trends firstly then decreased. The variability of EVLW/ITBV was similar with PVPI. No significantly different were found in△EVLWI (P=0.13),△PVPI (P=0.28) and△EVLW/ITBV (P=0.63)Conclusions There had been a marked increase in EVLW and lung capillary permeability after models were copied. EVLW could be decreased after the HFOV treatement for4hours. EVLW/ITBV and PVPI represent deteriorating firstly and then alleviating in ARDSexp, while no significance variability was found in ARDSp after the treatment of HFOV within4hours.No significantly different were found in the degree of reducting EVLW and lung capillary permeability under the therapy of HFOV4hours.