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If normal lung ventilation is maintained in this setting, severe local alkalosis might result.
The present study showed that low TV increases cardiac index and oxygen delivery in ARDS patients compared to high TV strategy, when minute ventilation is maintained constant.
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Ventilation was maintained by a Servo I ventilator (Maquet Critical Care, Solna, Sweden).
Positive pressure ventilation was maintained (Siemens Servo 900 C ventilator, Siemens, Elema, Sweden) in volume controlled mode, with a fraction of inspired oxygen of 0.4, positive end expiratory pressure of 5 cm H2O, frequency 16 breaths/min, tidal volume 6 8 mL/kg so as to achieve normocapnia (paCO2 4.6 5.3 kPa).
Bag-mask ventilation was maintained during the procedure.
Room temperature varied between 22 and 24 °C, and appropriate room ventilation was maintained.
The injurious ventilation was maintained until one of the following parameters was reached: ● An interval of 240 min of injurious ventilation.
Spontaneous ventilation was maintained after the first 10 μg; sursumvergence and weakened spontaneous ventilation were observed after 40 μg was administered.
Lung protective (LP) ventilation was maintained, according to a fixed protocol, by applying 6 ml/kg and 5 cm H2O positive end-expiratory pressure (PEEP).
Conventional non-protective ventilation was maintained during 90 min according to preliminary experiments demonstrating an optimal balance between the occurrence of reproducible ARDS and the need for a sufficient survival and follow-up after group allocation.
The same minute ventilation was maintained increasing respiratory rate: from 9 [8-9] to 18 [17-20] breaths/min in ARDS patients (p < 0.001), from 8 [7-10] to 18 [14-20] breaths/min in healthy lungs patients (p = 0.004) and from 10 [9-10] to 20 [20-21] in obese patients (p = 0.02) (Wilcoxon matched pairs test).
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