• Gabriel Ribeiro Madke, Eduardo Sperb Pilla, Pablo Geraldo Sanchez, Rafael Foernges, Gustavo Grün, Giovani Vendrami, Eduardo Fontena, Cristiano Feijó Andrade, and Paulo Francisco Guerreiro Cardoso.
• FFFCMPA, Brazil. gabrielmadke@gmail.com
• Acta Cir Bras. 2008 Jul 1;23(4):310-4.

PurposeTo evaluate the effects of alveolar recruitment based on mean airway pressure (MAP) on pig lungs submitted to thoracotomy through blood gas exchange and hemodynamic parameters.MethodsTwelve pigs weighting approximately 25 Kg were intubated and ventilated on volume controlled ventilation (tidal volume 10 ml/Kg, respiratory rate 16 min, FiO2 1.0, inspiratory:expiratory ratio 1:2, PEEP 5 cmH2O). The animals were then randomized into two groups: control and left lateral thoracotomy. The PEEP was increased at each 15-minute intervals to reach a MAP of 15, 20 and 25 cmH2O, respectively. Hemodynamic, gas exchange and respiratory mechanic data were measured immediately before each PEEP change.ResultsThere were no significant differences between both groups in all parameters analyzed (P=1.0). The PaO2, PaCO2, MAP, PAP and plateau pressure were significantly worse at MAP of 25 cmH2O, when compared with the other values of MAP (P=0.001, P=0.039, P=0.001, P=0.016 e P=0.027, respectively). The best pulmonary performance according to the analyzed parameters was observed at MAP of 20 cmH2O.ConclusionPEEP adjusted to MAP of 20 cmH2O resulted in best arterial oxygenation, without compromising the venous return, as opposed to MAP of 25 cmH2O, which caused deterioration of gas exchange, hemodynamics and respiratory mechanic.

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