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Articles in PresS, published online ahead of print October 12, 2001
J Appl Physiol, 10.1152/jap.00776.2001
Submitted on July 24, 2001
Accepted on October 10, 2001
1 Istituto di Fisiologia Umana I, University of Milan, Milan, Italy
2 Dipartimento di Medicina Clinica e Sperimentale, University of Padua, Padua, Italy
3 Meakins-Christie Laboratories, McGill University, Montreal, Quebec, Canada
* To whom correspondence should be addressed. E-mail: edgardo.dangelo{at}unimi.it.
Lung mechanics and morphometry of 10 normal open-chest rabbits (group A) mechanically ventilated (MV) with physiologic tidal volumes (VT=8-12 ml/kg) at zero end-expiratory pressure (ZEEP) for 3-4 h was compared to that of 5 rabbits (group B) after 3-4 h MV with PEEP of 2.3 cmH2O. Relative to initial MV on PEEP, MV on ZEEP caused a progressive increase in quasi-static elastance (Est; +36%), airway (Rint; +71%) and viscoelastic resistance (Rvisc; +29%) with no change in viscoelastic time constant. After restoration of PEEP, Est and Rvisc returned to control, whilst Rint remained elevated (+22%). On PEEP, MV had no effect on lung mechanics. Gas exchange on PEEP was equally preserved in groups A and B, and the lung wet/dry ratios were normal. Both groups had normal alveolar morphology, whilst only group A had injured respiratory and membranous bronchioles. In conclusion, prolonged MV on ZEEP induces histologic evidence of peripheral airway injury with concurrent increase in Rint, which persists after restoration of normal end-expiratory volumes. This is probably due to cyclic opening-closing of peripheral airways on ZEEP.
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