title: [Effects of electrical activity of diaphragm on the titration of positive end-expiratory pressure in a model of acute respiratory distress syndrome].
abstract: OBJECTIVE
  To explore the relationship of electrical activity of diaphragm (EAdi) and positive end-expiratory pressure (PEEP) in a rabbit model of acute respiratory distress syndrome (ARDS).
  
  
  METHODS
  The rabbit model of ARDS was induced by an intratracheal infusion of hydrochloric acid. After a sufficient amount of recruitment maneuvers (RM), the level: the PEEP levels were (10.4 ± 1.0) cm H2O in EAdi group and (9.7 ± 2.1) cm H2O in rabbits were divided into 2 groups: (1) PEEP titration with EAdi (EAdi group); (2) PEEP titration with maximum oxygenation (maximum oxygenation group). The tidal volume was 6 ml/kg in 2 groups. Pulmonary mechanics, gas exchange and hemodynamic were observed in two groups at baseline, after lung injury and ventilation 1, 2, 3 h respectively.
  
  
  RESULTS
  (1) PEEP maximum oxygenation group. There was no significant difference between two groups (P > 0.05). (2) Pulmonary mechanics:there was no significant difference in peak pressure (Ppeak) and mean pressure (Pm) between two groups at ventilation 1, 2, 3 h (P > 0.05). (3) Gas exchange: at ventilation 1, 2, 3 h, the oxygenation index (PaO2/FiO2) in EAdi group was higher than that of after lung injury (P < 0.05) and there was no significant difference in PaO2/FiO2 and partial pressure of arterial carbon dioxide (PaCO2) between two groups (P > 0.05). (4) Hemodynamic: at ventilation 1, 2, 3 h, the heart rate (HR) and mean artery pressure (MAP) in EAdi group had no significant differences with baseline, after lung injury and maximum oxygenation group (P > 0.05).
  
  
  CONCLUSIONS
  EAdi may be an ideal method for PEEP titration at post-RM in an ARDS model.
authors.affiliation: Department of Critical Care Medicine, Medical School of Yangzhou University, Yangzhou, China.
authors.forename: Xiao-yan
authors.initials: XY
authors.lastname: Wu
authors.forename: Rui-qiang
authors.initials: RQ
authors.lastname: Zheng
authors.forename: Huo-gen
authors.initials: HG
authors.lastname: Liu
authors.forename: Dong-ya
authors.initials: DY
authors.lastname: Huang
authors.forename: Ying-zi
authors.initials: YZ
authors.lastname: Huang
authors.forename: Hai-bo
authors.initials: HB
authors.lastname: Qiu
mesh_terms: D000818:Animals; D003964:Diaphragm / Q000503:physiopathology*; D004195:Disease Models, Animal; D011175:Positive-Pressure Respiration / Q000379:methods*; D011817:Rabbits; D012128:Respiratory Distress Syndrome / Q000503:physiopathology* / Q000628:therapy*; D013990:Tidal Volume