Pulmonary acid injury: effects of positive end-expiratory pressure and crystalloid vs colloid fluid resuscitation
A. B. Peitzman, G. T. Shires 3rd, H. Illner and G. T. Shires
Pulmonary acid aspiration results in hypoxemia and hypovolemia. We assessed
the effects of positive end-expiratory pressure (PEEP) and fluid
resuscitation on oxygenation and alveolar-capillary membrane permeability
after acid aspiration. Alveolar-capillary membrane permeability was
assessed by determination of extravascular lung water volume, using the
thermal-green dye double-indicator technique, extravasation of iodinated 1
125 serum albumin into lung parenchyma, and albumin leak into the alveolar
spaces. The data from this study demonstrated that PEEP improved
oxygenation after acid aspiration, but did not alter progression of the
injury; cardiac output and oxygen transport were improved by plasma volume
repletion while receiving PEEP; and resuscitation with 5% albumin solution
increased plasma albumin content and tracheal albumin content
commensurately and did not modify progression of the injury.
