The Effect of Positive End-Expiratory Pressure on Lung Micromechanics Assessed by Synchrotron Radiation Computed Tomography in an Animal Model of ARDS

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Scaramuzzo , G , Broche , L , Pellegrini , M , Porra , L , Derosa , S , Tannoia , A P , Marzullo , A , Borges , J B , Bayat , S , Bravin , A , Larsson , A & Perchiazzi , G 2019 , ' The Effect of Positive End-Expiratory Pressure on Lung Micromechanics Assessed by Synchrotron Radiation Computed Tomography in an Animal Model of ARDS ' , Journal of clinical medicine , vol. 8 , no. 8 , 1117 . https://doi.org/10.3390/jcm8081117

Title: The Effect of Positive End-Expiratory Pressure on Lung Micromechanics Assessed by Synchrotron Radiation Computed Tomography in an Animal Model of ARDS
Author: Scaramuzzo, Gaetano; Broche, Ludovic; Pellegrini, Mariangela; Porra, Liisa; Derosa, Savino; Tannoia, Angela Principia; Marzullo, Andrea; Borges, Joao Batista; Bayat, Sam; Bravin, Alberto; Larsson, Anders; Perchiazzi, Gaetano
Contributor: University of Helsinki, HUS Medical Imaging Center
Date: 2019-08
Language: eng
Number of pages: 13
Belongs to series: Journal of clinical medicine
ISSN: 2077-0383
URI: http://hdl.handle.net/10138/305606
Abstract: Modern ventilatory strategies are based on the assumption that lung terminal airspaces act as isotropic balloons that progressively accommodate gas. Phase contrast synchrotron radiation computed tomography (PCSRCT) has recently challenged this concept, showing that in healthy lungs, deflation mechanisms are based on the sequential de-recruitment of airspaces. Using PCSRCT scans in an animal model of acute respiratory distress syndrome (ARDS), this study examined whether the numerosity (ASnum) and dimension (ASdim) of lung airspaces change during a deflation maneuver at decreasing levels of positive end-expiratory pressure (PEEP) at 12, 9, 6, 3, and 0 cmH(2)O. Deflation was associated with significant reduction of ASdim both in the whole lung section (passing from from 13.1 +/- 2.0 at PEEP 12 to 7.6 +/- 4.2 voxels at PEEP 0) and in single concentric regions of interest (ROIs). However, the regression between applied PEEP and ASnum was significant in the whole slice (ranging from 188 +/- 52 at PEEP 12 to 146.4 +/- 96.7 at PEEP 0) but not in the single ROIs. This mechanism of deflation in which reduction of ASdim is predominant, differs from the one observed in healthy conditions, suggesting that the peculiar alveolar micromechanics of ARDS might play a role in the deflation process.
Subject: ARDS
recruitment
VILI
alveoli
kinetics
synchrotron radiation computed tomography
ACUTE RESPIRATORY-DISTRESS
MECHANICAL VENTILATION
SURFACE-TENSION
VOLUME
STRESS
INFLATION
STRAIN
TIME
RECRUITMENT
DENSITY
217 Medical engineering
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