Development of new method of mechanical ventilation reducing transpulmonary pressure

2017 Fiscal Year Final Research Report

• Project/Area Number: 15K10535
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Anesthesiology
• Research Institution: Osaka University
• Principal Investigator: Uchiyama Akinori 大阪大学, 医学系研究科, 准教授 (00324856)
• Co-Investigator(Kenkyū-buntansha): 藤野 裕士 大阪大学, 医学系研究科, 教授 (50252672) ; 吉田 健史 大阪大学, 医学部附属病院, 医員 (50725520)
• Research Collaborator: YAMASHITA Tomonori ; KOYAMA Yukiko ; YOSHIDA Takeshi
• Project Period (FY): 2015-04-01 – 2018-03-31
• Keywords: 人工呼吸 / 自発呼吸 / 肺保護換気 / 重炭酸ナトリウム / トリメタロール / 呼吸性アシドーシス / PEEP

Outline of Final Research Achievements

Transpulmonary pressure PL (= airway pressure - intrathoracic pressure) is involved in the mechanical ventilation-associated lung injuries. PL is increased by a strong spontaneous breathing effort. The purpose of this study is to develop a method that can suppress spontaneous respiratory effort and reduce PL. Intravenous administration of alkalizing agents and adjustment of PEEP level were used for control of spontaneous respiratory effort. Sodium bicarbonate and THAM (tromethamine) were used as alkalizing agents. We used a rabbit model with respiratory failure. Administration of the alkalizing agents decreased minute ventilation. THAM has more effective than sodium bicarbonate. There was a possibility that THAM and sodium bicarbonate had a difference in the transition to cerebrospinal fluid. When PEEP during mechanical ventilation was set to a value that maximized pulmonary compliance, PL can be reduced and lung protection ventilation will be obtained.

Free Research Field

集中治療医学