Lung anatomy, energy load, and ventilator-induced lung injury
| Autor: | Emiliano Votta, Daniele Dondossola, Beatrice Comini, Valentina Melis, M Monti, Luciano Gattinoni, P. Pugni, Davide T. Andreis, Eleonora Carlesso, Luciano Lombardi, M. Milesi, G. Iapichino, Stefano Gatti, Alessandro Santini, Alessandro Protti |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
medicine.medical_specialty
Pathology Energy load medicine.medical_treatment Lung injury Critical Care and Intensive Care Medicine Inspiratory Capacity Functional residual capacity Mechanical ventilation Lung anatomy Edema Internal medicine medicine Tidal volume Ventilator-induced lung injury business.industry Research Experimental animal model respiratory system Inspiratory capacity Lung stress and strain respiratory tract diseases Cardiology medicine.symptom business |
| Zdroj: | Intensive Care Medicine Experimental |
| ISSN: | 2197-425X |
| DOI: | 10.1186/s40635-015-0070-1 |
| Popis: | Background High tidal volume can cause ventilator-induced lung injury (VILI), but positive end-expiratory pressure (PEEP) is thought to be protective. We aimed to find the volumetric VILI threshold and see whether PEEP is protective per se or indirectly. Methods In 76 pigs (22 ± 2 kg), we examined the lower and upper limits (30.9–59.7 mL/kg) of inspiratory capacity by computed tomography (CT) scan at 45 cmH2O pressure. The pigs underwent a 54-h mechanical ventilation with a global strain ((tidal volume (dynamic) + PEEP volume (static))/functional residual capacity) from 0.45 to 5.56. The dynamic strain ranged from 18 to 100 % of global strain. Twenty-nine pigs were ventilated with end-inspiratory volumes below the lower limit of inspiratory capacity (group “Below”), 38 within (group “Within”), and 9 above (group “Above”). VILI was defined as death and/or increased lung weight. Results “Below” pigs did not develop VILI; “Within” pigs developed lung edema, and 52 % died before the end of the experiment. The amount of edema was significantly related to dynamic strain (edema 188–153 × dynamic strain, R2 = 0.48, p |
| Databáze: | OpenAIRE |
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