Mechanical ventilation strategies targeting different magnitudes of collapse and tidal recruitment in porcine acid aspiration-induced lung injury

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dc.creatorJuliane Haase
dc.creatorPeter Spieth
dc.creatorClaudia Gittel
dc.creatorThomas Muders
dc.creatorHermann Wrigge
dc.creatorAndreas Reske
dc.creatorDorina Buchloh
dc.creatorSören Hammermüller
dc.creatorPeter Salz
dc.creatorJulia Mrongowius
dc.creatorNadja Carvalho
dc.creatorAlessandro Beda
dc.creatorAnna Rau
dc.creatorHenning Starke
dc.date.accessioned2025-05-15T14:36:27Z
dc.date.accessioned2025-09-08T23:07:45Z
dc.date.available2025-05-15T14:36:27Z
dc.date.issued2019
dc.identifier.doihttps://doi.org/10.3390/jcm8081250
dc.identifier.issn2077-0383
dc.identifier.urihttps://hdl.handle.net/1843/82305
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofJournal of clinical medicine
dc.rightsAcesso Aberto
dc.subjectSistemas dinâmicos
dc.subjectDoenças pulmonaresDeCS
dc.subject.otheracute respiratory distress syndrome; electrical impedance tomography; lung protective mechanical ventilation; lung recruitment; positive end-expiratory pressure
dc.titleMechanical ventilation strategies targeting different magnitudes of collapse and tidal recruitment in porcine acid aspiration-induced lung injury
dc.typeArtigo de periódico
local.citation.issue8
local.citation.spage1250
local.citation.volume8
local.description.resumoReducing ventilator-associated lung injury by individualized mechanical ventilation (MV) in patients with Acute Respiratory Distress Syndrome (ARDS) remains a matter of research. We randomly assigned 27 pigs with acid aspiration-induced ARDS to three different MV protocols for 24 h, targeting different magnitudes of collapse and tidal recruitment (collapse&TR): the ARDS-network (ARDSnet) group with low positive end-expiratory pressure (PEEP) protocol (permissive collapse&TR); the Open Lung Concept (OLC) group, PaO2/FiO2 >400 mmHg, indicating collapse&TR <10%; and the minimized collapse&TR monitored by Electrical Impedance Tomography (EIT) group, standard deviation of regional ventilation delay, SDRVD. We analyzed cardiorespiratory parameters, computed tomography (CT), EIT, and post-mortem histology. Mean PEEP over post-randomization measurements was significantly lower in the ARDSnet group at 6.8 ± 1.0 cmH2O compared to the EIT (21.1 ± 2.6 cmH2O) and OLC (18.7 ± 3.2 cmH2O) groups (general linear model (GLM) p < 0.001). Collapse&TR and SDRVD, averaged over all post-randomization measurements, were significantly lower in the EIT and OLC groups than in the ARDSnet group (collapse p < 0.001, TR p = 0.006, SDRVD p < 0.004). Global histological diffuse alveolar damage (DAD) scores in the ARDSnet group (10.1 ± 4.3) exceeded those in the EIT (8.4 ± 3.7) and OLC groups (6.3 ± 3.3) (p = 0.16). Sub-scores for edema and inflammation differed significantly (ANOVA p < 0.05). In a clinically realistic model of early ARDS with recruitable and nonrecruitable collapse, mechanical ventilation involving recruitment and high-PEEP reduced collapse&TR and resulted in improved hemodynamic and physiological conditions with a tendency to reduced histologic lung damage.
local.publisher.countryBrasil
local.publisher.departmentENG - DEPARTAMENTO DE ENGENHARIA ELETRÔNICA
local.publisher.initialsUFMG
local.url.externahttps://www.mdpi.com/2077-0383/8/8/1250

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