Pulmonary clearance of inhaled [99Tcm]DTPA: effects of ventilation pattern

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Abstract
While a rise in lung volume in known to increase the pulmonary clearance of technetium-99m-labelled dietylene triamine pentaacetate [(99Tcm]DTPA), little interest has been focused on the effects of changes in ventilation frequency, tidal volume and airway pressure. We studied adult, anaesthetized and intubated rabbits during three ventilation patterns (VP) using pressure controlled ventilation (ServoVentilator 900C). VP was either deep slow (f = 20 min-1, tidal volume (VT) = 30 .+-. 4 ml kg-1 and positive end-expiratory pressure (PEEP) = 0.2 kPa [VP 20/0.2, n = 8]) or rapid shallow (f = 80 min-1, VT = 11 .+-. 2 ml kg-1 and PEEP = 0.2 or 0.4 kPa [VP 80/0.2, n = 6 and VP 80/0.4, n = 6]). The mean airway pressure was similar at VP 20/0.2 and VP 80/0.4. During administration of [99Tcm]DTPA aerosol all animals were ventilated under the same conditions (f = 40 min-1 and PEEP = 0.2 kPa). The pulmonary clearance rat expressed as the half-life time (T1/2) of [99Tcm]DTPA was at VP 80/0.2 = 113 .+-. 31 min, at VP 80/0.4 = 70 .+-. 24 min (P < 0.01 compared to VP 80/0.2) and at VP 20/0.2 = 36 .+-. 18 min (P < 0.001 compared to VP 80/0.2 and P < 0.01 compared to VP 80/0.4). We conclude that the pulmonary clearance of [99Tcm]DTPA increases (1) during rapid shallow ventilation when PEEP is increased from 0.2 to 0.4 kPa; (2) during deep slow ventilation relative to rapid shallow ventilation even when the mean airway pressure is similar.