Using injury cost functions from a predictive single-compartment model to assess the severity of mechanical ventilator-induced lung injuries
| Autor: | Bradford J. Smith, Katharine L. Hamlington, Michelle M. Mellenthin, Gregory S. Roy, Siyeon A. Seong, Jason H. T. Bates, Elizabeth Bartolak-Suki |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Physiology
Single compartment Ventilator-Induced Lung Injury medicine.medical_treatment Strain (injury) 030204 cardiovascular system & hematology Lung injury Positive-Pressure Respiration Mice 03 medical and health sciences 0302 clinical medicine Mechanical ventilator Physiology (medical) Tidal Volume Animals Medicine Computer Simulation Lung Lung function Mechanical ventilation Mice Inbred BALB C Respiratory Distress Syndrome business.industry Respiration respiratory system medicine.disease Respiration Artificial medicine.anatomical_structure 030228 respiratory system Anesthesia business Algorithms Research Article |
| Zdroj: | J Appl Physiol (1985) |
| ISSN: | 1522-1601 8750-7587 |
| DOI: | 10.1152/japplphysiol.00770.2018 |
| Popis: | Identifying safe ventilation patterns for patients with acute respiratory distress syndrome remains challenging because of the delicate balance between gas exchange and selection of ventilator settings to prevent further ventilator-induced lung injury (VILI). Accordingly, this work seeks to link ventilator settings to graded levels of VILI to identify injury cost functions that predict injury by using a computational model to process pressures and flows measured at the airway opening. Pressure-volume loops were acquired over the course of ~2 h of mechanical ventilation in four different groups of BALB/c mice. A cohort of these animals were subjected to an injurious bronchoalveolar lavage before ventilation. The data were analyzed with a single-compartment model that predicts recruitment/derecruitment and tissue distension at each time step in measured pressure-volume loops. We compared several injury cost functions to markers of VILI-induced blood-gas barrier disruption. Of the cost functions considered, we conclude that mechanical power dissipation and strain heterogeneity are the best at distinguishing between graded levels of injury and are good candidates for forecasting the development of VILI. NEW & NOTEWORTHY This work uses a predictive single-compartment model and injury cost functions to assess graded levels of mechanical ventilator-induced lung injury. The most promising measures include strain heterogeneity and mechanical power dissipation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|