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Effects of pressure-support ventilation on recovery from acute diaphragmatic fatigue in rabbits
A Uchiyama1, H Imanaka, M Nishimura
1Department of Anesthesiology, Osaka Prefectural General Hospital, Japan.
Objectives:
To examine the effects of pressure-support ventilation on recovery from acute diaphragmatic fatigue.
Design:
Prospective laboratory trial.
Setting:
Experimental laboratory.
Subjects:
Twenty-one healthy, adult New Zealand white rabbits.
Interventions:
Diaphragmatic fatigue was induced with 50-Hz phrenic nerve stimulation for 30 mins. Recovery was compared between pressure-support ventilation 0 cm H2O (SB), 10 cm H2O (P10), and 20 cm H2O (P20) for 90 mins immediately after the end of the fatigue inducing procedure.
Measurements And Main Results:
After the fatigue-inducing procedure, pressure-support ventilation reduced transdiaphragmatic pressure and integrated diaphragmatic electromyogram both at P20 and P10, but not in SB. Recovery was assessed by airway occlusion pressure (Poccl) generated by high- (100 Hz) and low- (20 Hz) frequency phrenic nerve stimulation. Poccl at 100 Hz was lower in P10 and P20 than in SB (74.6 +/- 6.2 [SEM] %, 66.9 +/- 3.3%, and 94.8 +/- 3.6% of the baseline at 90 mins for P10, P20, and SB, respectively), while those at 20 Hz showed no differences between the three groups.
Conclusion:
Recovery from acute diaphragmatic fatigue might be disturbed with pressure-support ventilation.