title: Effects of various ventilation modes on immunocompetence in surgical patients.
abstract: The effects of controlled mechanical ventilation with PEEP (CMV), and spontaneous ventilation with continuous positive airway pressure (CPAP), CPAP with high frequency ventilation (CPAP-HFV) and spontaneous respiration without CPAP (SV) on immunocompetence were compared in open-heart surgery patients undergoing the weaning phase. T-lymphocyte and T-helper cell ratios decreased during CPAP (P less than 0.01) and SV (P less than 0.05). PWM-induced lymphocyte proliferative responses were decreased during CPAP-HFV (P less than 0.05), CPAP and SV (P less than 0.01) in whole blood and separated lymphocyte cultures compared to values during CMV. Con A-induced responses were also depressed during SV in whole blood cultures (P less than 0.01). When the synthesis and secretion of immunoglobulins were studied, only IgM production showed a decrease in PWM-stimulated cultures during SV (P less than 0.05). In spite of an increase in the cardiac index in the three spontaneous ventilation modes compared to CMV, a slight decrease instead of an immediate improvement was seen in immune responses on weaning to spontaneous ventilation modes.
authors.affiliation: Department of Anaesthesiology, University of Turku, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Perttilä
authors.forename: M
authors.initials: M
authors.lastname: Salo
authors.forename: A
authors.initials: A
authors.lastname: Vuori
authors.forename: A
authors.initials: A
authors.lastname: Heikelä
mesh_terms: D001026:Coronary Artery Bypass; D005260:Female; D006439:Hemodynamics; D006612:High-Frequency Ventilation; D006801:Humans; D007121:Immunocompetence; D007136:Immunoglobulins / Q000096:biosynthesis; D007958:Leukocyte Count; D008213:Lymphocyte Activation; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D012121:Respiration, Artificial; D015300:Ventilator Weaning
chemical_list: D007136:Immunoglobulins