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Anesth Analg 2006;102:1201-1206
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000198664.74731.d3

CRITICAL CARE AND TRAUMA

Regional Blood Flow in Respiratory Muscles During Partial Ventilatory Assistance in Rabbits

Akinori Uchiyama*, Yuji Fujino*, Kikumi Hosotsubo*, Eriko Miyoshi*, Takashi Mashimo*, and Masaji Nishimura{dagger}

*Osaka University Hospital Intensive Care Unit, Yamadaoka, Suita; and {dagger}Department of Emergency and Critical Care Medicine, University of Tokushima Graduate School, Kuramotocho, Tokushima, Japan

Address correspondence and reprint requests to Akinori Uchiyama, Osaka University Hospital Intensive Care Unit, 2-15 Yamadaoka, Suita, Osaka Prefecture 565-0871, Japan. Address e-mail to auchiyama{at}hp-icu.med.osaka-u.ac.jp.

We tested the hypothesis that even partial ventilatory assistance would reduce respiratory muscle blood flow to levels similar to those found during control mechanical ventilation (CMV). Three levels of pressure support ventilation (PSV) and 2 CMV settings were compared in 10 rabbits. PSV 0, 6, and 12 cm H2O, under continuous positive airway pressure mode, were applied, and then pressure control ventilation (PCV) values of 6 (36 breaths/min) and 12 cm H2O (18 per breaths/min) were applied to each CMV setting with a muscle relaxant. Using colored microspheres, we measured regional tissue blood flow in respiratory muscles, lower extremities, kidney, and liver. Regional tissue blood flow in the diaphragm during PSV6, PCV6, and PCV12 were less than those during PSV0. During PSV12, blood flow in the crural diaphragm was more than that during PCV12 and similar to that during PSV0. Whereas the transdiaphragmatic pressure of PSV6 was –0.8 ± 1.6 cm H2O, that of PSV12 was –3.1 ± 2.4 cm H2O. Inspiratory asynchrony, arising from an ineffective triggering effort, was observed in PSV12. The ventilatory settings did not affect blood flow of the lower extremities, liver, and kidney. In conclusion, ventilatory settings affected blood flow in the diaphragm. At certain PSV settings, blood flow in the diaphragm was minimal.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.