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Biphasic positive airway pressure (BIPAP) allows unrestricted spontaneous breathing throughout mechanical ventilation. Effects of spontaneous breathing during BIPAP on pulmonary gas exchange were studied on a randomized basis in 12 dogs with oleic acid-induced lung injury using the multiple inert gas elimination technique. Spontaneous breathing during BIPAP, accounting for 10% of minute ventilation (VE), increased PaO2 from 61 +/- 2 to 78 +/- 3 mm Hg (mean +/- SE) (p 100) areas (p < 0.05). Spontaneous breaths superimposed on mechanical ventilation may convert shunt VA/Q units to normal by increased ventilation of poorly or nonventilated units and/or increase blood flow to previously minimal or nonperfused areas.
Putensen et al. (Fri,) studied this question.