Experimental blunt chest trauma – cardiorespiratory effects of different mechanical ventilation strategies with high positive end-expiratory pressure: a randomized controlled study

Schreiter, Dierk; Carvalho, Nadja C.; Katscher, Sebastian; Mende, Ludger; Reske, Alexander P.; Spieth, Peter M.; Carvalho, Alysson R.; Beda, Alessandro; Lachmann, Burkhard; Amato, Marcelo B. P.; Wrigge, Hermann; Reske, Andreas W.

doi:10.1186/s12871-015-0166-x

Table 1 Respiratory and hemodynamic parameters

From: Experimental blunt chest trauma – cardiorespiratory effects of different mechanical ventilation strategies with high positive end-expiratory pressure: a randomized controlled study

	Group	BAL	RAN	1 h	6 h	12 h	18 h	24 h	Group effect
RR (breaths*min-1)	HFPPV	20 ± 0	20 ± 0^ns	69.6 ± 11.7	65.6 ± 12.0	64.0 ± 13.2	62.4 ± 14.3	64.2 ± 14.2	P < 0.01
RR (breaths*min-1)	HP-CMV	20 ± 0	20 ± 0^ns	21 ± 1.8	21 ± 2.3	20.7 ± 1.8	20.7 ± 1.8	20.4 ± 1.3	P < 0.01
ΔP (cmH2O)	HFPPV	18.8 ± 5.1	28.4 ± 8.5*	11.8 ± 3.2	9.6 ± 3.3	8.7 ± 2.8	9.3 ± 2.8	8.2 ± 2.6	ns
ΔP (cmH2O)	HP-CMV	16.0 ± 4.0	25.2 ± 9.3*	11.1 ± 3.3	10.7 ± 3.0	9.8 ± 3.0	11.2 ± 3.0	10.8 ± 3.0	ns
MAP (mmHg)	HFPPV	83.3 ± 12.8	84.1 ± 14.4^ns	80.8 ± 13.0	78.2 ± 10.9	81.1 ± 14.3	81.0 ± 13.2	72.6 ± 13.5	P = 0.04
MAP (mmHg)	HP-CMV	85.5 ± 14.9	87.2 ± 14.7^ns	83.0 ± 12.2	87.6 ± 15.3	87.1 ± 16.5	91.3 ± 16.4	85.7 ± 13.1	P = 0.04
MPAP (mmHg)	HFPPV	28.6 ± 5.4	32.2 ± 5.5*	32.5 ± 8.7	28.7 ± 4.2	28.0 ± 3.7	29.6 ± 5.3	28.0 ± 4.3	ns
MPAP (mmHg)	HP-CMV	25.7 ± 3.7	29.4 ± 4.7*	34.2 ± 5.7	33.0 ± 5.4	31.8 ± 5.0	30.1 ± 7.1	30.3 ± 8.0	ns
CVP (mmHg)	HFPPV	9.6 ± 4.5	9.7 ± 4.5^ns	14.2 ± 3.4	12.8 ± 3.0	12.2 ± 3.4	12.2 ± 3.4	12.3 ± 3.8	ns
CVP (mmHg)	HP-CMV	10.3 ± 4.2	11.2 ± 4.0^ns	12.3 ± 2.5	11.4 ± 2.6	12.4 ± 3.4	11.1 ± 2.6	11.1 ± 3.0	ns
PCWP (mmHg)	HFPPV	15.4 ± 2.5	16.7 ± 4.7^ns	18.8 ± 3.2	17.0 ± 2.6	17.2 ± 3.5	17.5 ± 3.9	16.3 ± 2.5	ns
PCWP (mmHg)	HP-CMV	15.7 ± 3.3	16.4 ± 2.6^ns	17.8 ± 3.1	17.2 ± 3.0	17.0 ± 4.3	16.0 ± 3.8	16.0 ± 4.6	ns
HR (min-1)	HFPPV	125 ± 14	109 ± 21*	115 ± 17	119 ± 25	127 ± 17	128 ± 13	126 ± 26	ns
HR (min-1)	HP-CMV	121 ± 16	104 ± 20*	124 ± 27	127 ± 17	132 ± 11	141 ± 19	137 ± 18	ns
CO (L*min-1)	HFPPV	8.0 ± 2.3	6.5 ± 2.5*	5.8 ± 3.8	3.9 ± 0.8	4.4 ± 1.1	4.4 ± 1.5	3.8 ± 0.9	P < 0.01
CO (L*min-1)	HP-CMV	6.9 ± 1.4	6.0 ± 1.1*	5.5 ± 1.2	5.5 ± 2.3	5.5 ± 1.5	6.2 ± 1.0	5.3 ± 0.8	P < 0.01
VO₂ (ml O2*min-1)	HFPPV	392 ± 134	341 ± 206^ns	306 ± 90	280 ± 89	317 ± 132	289 ± 131	244 ± 100	ns
VO₂ (ml O2*min-1)	HP-CMV	288 ± 110	244 ± 101^ns	238 ± 81	281 ± 160	286 ± 159	301 ± 143	270 ± 97	ns
DO₂ (ml O₂*min-1)	HFPPV	1040 ± 254	833 ± 290*	653 ± 171	539 ± 110	612 ± 151	615 ± 208	529 ± 123	ns
DO₂ (ml O₂*min-1)	HP-CMV	903 ± 176	778 ± 153*	678 ± 160	699 ± 297	687 ± 217	662 ± 130	654 ± 106	ns

Respiratory and hemodynamic parameters observed in the high frequency inverse ration pressure controlled ventilation (HFPPV) and low tidal volume high PEEP ventilation (HP-CMV) groups. Respiratory rate (RR), driving pressure (ΔP), mean arterial pressure (MAP), mean pulmonary arterial blood pressure (MPAP), central venous pressure, pulmonary capillary wedge pressure (PCWP), heart rate (HR), cardiac output (CO), oxygen consumption and delivery VO₂ and DO₂, respectively). Data are shown as mean and standard deviation. BAL: baseline, RAN: randomization, ns: not significant (P > 0.05). The superscripts in the RAN column refer to statistical significance of the comparison to BAL; *P < 0.05. Group effect (last column) indicates the statistical significance of between-group differences detected by GLM analysis of changes after randomization

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