title: Efficacy of tracheal insufflation of oxygen during oleic acid-induced pulmonary edema.
abstract: OBJECTIVE
  To determine whether tracheal insufflation of oxygen (TRIO) might be useful in field resuscitation of casualties with lung dysfunction.
  
  
  METHODS
  Physiological measurements of cardiac and respiratory function were compared before and after oleic acid lung injury.
  
  
  METHODS
  Beagles were studied in a laboratory.
  
  
  METHODS
  Oleic acid (0.06 mL/kg) was injected over four minutes into the central venous port of a pulmonary artery catheter. Measurements were made during 30 minutes of TRIO before and after acute lung injury.
  
  
  METHODS
  Hemodynamic and respiratory measurements, including intravascular pressures, heart rate, cardiac output, blood gases, respiratory system compliance, and O2 consumption were recorded during conventional mechanical ventilation and TRIO.
  
  
  RESULTS
  Before acute lung injury, PaO2 (mean +/- SD) increased (P less than .05) from 96 +/- 7.4 (13 +/- 1.0 kPa) during conventional mechanical ventilation to 360 +/- 123 mm Hg (48 +/- 16.4 kPa) after TRIO. PaCO2 (mean +/- SD) increased (P less than .05) from 39.5 +/- 1.1 (5.3 +/- 0.1 kPa) to 102 +/- 27.4 mm Hg (13.6 +/- 3.6 kPa). Arterial and mixed venous pH values decreased in proportion to PCO2. After acute lung injury, compliance decreased. PAO2 decreased (P less than .05) to 58 +/- 8.4 mm Hg (7.7 +/- 1.1 kPa) during conventional mechanical ventilation and increased (P less than .05) to 84 +/- 19.6 mm Hg (11.2 +/- 2.6 kPa) after 30 minutes of TRIO.
  
  
  CONCLUSIONS
  Despite poor gas exchange after acute lung injury, TRIO maintained adequate oxygenation and may be useful for emergency ventilation even when pulmonary edema complicates resuscitation.
authors.affiliation: Department of Anesthesiology, University of Maryland, School of Medicine, Baltimore.
authors.forename: J E
authors.initials: JE
authors.lastname: Mendham
authors.forename: E M
authors.initials: EM
authors.lastname: McGrady
authors.forename: C F
authors.initials: CF
authors.lastname: Mackenzie
authors.forename: G M
authors.initials: GM
authors.lastname: Barnas
authors.forename: B
authors.initials: B
authors.lastname: Fahy
authors.forename: M K
authors.initials: MK
authors.lastname: Ewing
mesh_terms: D000818:Animals; D002245:Carbon Dioxide / Q000097:blood; D003413:Cricoid Cartilage / Q000601:surgery; D004285:Dogs; D006439:Hemodynamics; D007442:Intubation, Intratracheal / Q000379:methods; D019301:Oleic Acid; D009829:Oleic Acids; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011654:Pulmonary Edema / Q000097:blood / Q000139:chemically induced / Q000628:therapy*; D012121:Respiration, Artificial / Q000379:methods*; D015656:Respiratory Mechanics; D013957:Thyroid Cartilage / Q000601:surgery
chemical_list: D009829:Oleic Acids; D002245:Carbon Dioxide; D019301:Oleic Acid; D010100:Oxygen