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.

Scaramuzzo, G., Broche, L., Pellegrini, M., Porra, L., Derosa, S., Tannoia, A., et al. (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, 8(8) [10.3390/jcm8081117].

The effect of positive end-expiratory pressure on lung micromechanics assessed by synchrotron radiation computed tomography in an animal model of ARDS

Bravin A
Membro del Collaboration Group
;
2019

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.
Articolo in rivista - Articolo scientifico
Alveoli; ARDS; Kinetics; Recruitment; Synchrotron radiation computed tomography; VILI;
English
2019
8
8
1117
open
Scaramuzzo, G., Broche, L., Pellegrini, M., Porra, L., Derosa, S., Tannoia, A., et al. (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, 8(8) [10.3390/jcm8081117].
File in questo prodotto:
File Dimensione Formato  
Scaramuzzo_JCM_2019.pdf

accesso aperto

Tipologia di allegato: Publisher’s Version (Version of Record, VoR)
Dimensione 920.96 kB
Formato Adobe PDF
920.96 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/342545
Citazioni
  • Scopus 7
  • ???jsp.display-item.citation.isi??? 8
Social impact