Effect of different levels of positive end-expiratory pressure on lung water content

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Abstract
To compare the effects of 2-, 5- and 10-cm H2O positive end-expiratory pressure (PEEP) on pulmonary extravascular water volume (PEWV), pulmonary blood volume (PBV), pulmonary dry weight (PDW) and distensibility, perfused dogs'' lungs were separately ventilated in situ and pulmonary edema was produced with oleic acid (0.06 ml/kg). Three groups were studied: PEEP 5 cm H2O in both lungs; PEEP 2 cm H2O in 1 lung and 10 cm H2O in the other; and PEEP, same as the previous condition, but the chest was rotated to compensate for differences in heights. The PEWV and distensibility were less (P < 0.05) in lungs exposed to 10 cm H2O than to either 2 or 5 cm H2O PEEP. After chest rotation, the difference between 10 and 2 cm H2O PEEP on PEWV was eliminated but that on distensibility was not. Ten cm H2O PEEP decreased water content because of lung volume-induced effects on intravascular hydrostatic pressure and improved distensibility by recruitment of alveoli, irrespective of PEWV.