Mechanical Ventilation Strategies Targeting Different Magnitudes of Collapse and Tidal Recruitment in Porcine Acid Aspiration-Induced Lung Injury
Abstract
:1. Introduction
2. Materials and Methods
2.1. Animal Handling and Preparation
2.2. Acid Aspiration-Induced Pulmonary Acute Respiratory Distress Syndrome
2.3. Individualization of PEEP and Mechanical Ventilation
2.4. Quantitative Computed Tomography (qCT)
2.5. Electrical Impedance Tomography
2.6. Tissue Processing and Histological Analysis
2.7. Statistical Analysis
3. Results
3.1. General Aspects and Effects of Induction of ARDS
3.2. Effects on Lung Morphology and Function
3.3. Hemodynamics and Systemic Physiological Parameters
3.4. Assessment of Edema and Histology
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Group | Baseline | ARDS | 4 h | 8 h | 12 h | 16 h | 20 h | 24 h | |
---|---|---|---|---|---|---|---|---|---|
HR aa, bbb (min−1) | ARDSnet OLC EIT | 103 ± 23 | 80 ± 12 | 105 ± 15 | 104 ± 13 | 106 ± 9 | 108 ± 16 | 105 ± 20 | 114 ± 12 |
93 ± 13 | 113 ± 16 | 115 ± 13 | 109 ± 11 | 110 ± 17 | 117 ± 10 | 116 ± 18 | |||
84 ± 15 | 103 ± 23 | 110 ± 16 | 114 ± 15 | 116 ± 25 | 115 ± 15 | 114 ± 23 | |||
MAP bbb (mmHg) | ARDSnet OLC EIT | 87 ± 20 | 82 ± 12 | 89 ± 13 | 83 ± 11 | 81 ± 13 | 79 ± 13 | 75 ± 9 | 70 ± 8 |
94 ± 10 | 76 ± 14 | 75 ± 8 | 78 ± 7 | 73 ± 11 | 76 ± 12 | 71 ± 10 | |||
91 ± 17 | 80 ± 15 | 75 ± 12 | 71 ± 5 | 72 ± 11 | 70 ± 5 | 63 ± 11 | |||
CO (L·min−1) | ARDSnet OLC EIT | 5.6 ± 1.6 | 5.0 ± 1.6 | 5.8 ± 2.6 | 5.2 ± 1.7 | 5.3 ± 0.9 | 5.4 ± 0.9 | 5.4 ± 1.1 | 6.2 ± 0.8 |
5.6 ± 1.3 | 4.3 ± 1.0 | 4.2 ± 1.1 | 4.3 ± 0.8 | 4.6 ± 0.8 | 4.8 ± 0.6 | 4.7 ± 0.9 | |||
4.8 ± 1.3 | 4.0 ± 1.2 | 4.8 ± 1.1 | 4.6 ± 1.5 | 4.6 ± 1.4 | 4.7 ± 1.2 | 5.0 ± 1.2 | |||
SVR a, bbb (dyn·s·cm−5) | ARDSnet OLC EIT | 1186 ± 430 | 1660 ± 954 | 1334 ± 524 | 1370 ± 539 | 1151 ± 314 | 1078 ± 162 | 1041 ± 201 | 888 ± 212 |
1331 ± 338 | 1510 ± 478 | 1353 ± 499 | 1246 ± 289 | 1185 ± 331 | 1145 ± 222 | 1047 ± 154 | |||
1409 ± 227 | 1604 ± 1046 | 1206 ± 214 | 1201 ± 475 | 1156 ± 491 | 1123 ± 496 | 1069 ± 450 | |||
PVR aaa, bb (dyn·s·cm−5) | ARDSnet OLC EIT | 167 ± 73 | 391 ± 173 | 394 ± 157 | 412 ± 115 | 350 ± 112 | 324 ± 120 | 249 ± 90 | 268 ± 55 |
234 ± 69 | 323 ± 156 | 260 ± 140 | 274 ± 133 | 270 ± 90 | 250 ± 92 | 245 ± 76 | |||
333 ± 128 | 431 ± 252 | 352 ± 129 | 291 ± 131 | 219 ± 77 | 240 ± 81 | 235 ± 112 | |||
PEEP bbb, ccc, ddd (cmH20) | ARDSnet eee, fff OLC EIT | 5.0 ± 0 | 5.0 ± 0 | 7.9 ± 3.1 | 7.1 ± 1.9 | 6.1 ± 1.6 | 6.4 ± 2 | 6.9 ± 1.6 | 6.5 ± 1.6 |
5.0 ± 0 | 18 ± 3.5 | 18.0 ± 3.5 | 19.0 ± 3.2 | 19.0 ± 3.2 | 19.0 ± 3.2 | 19.0 ± 3.2 | |||
5.0 ± 0 | 19.5 ± 2.1 | 20.0 ± 3.2 | 21.8 ± 3.3 | 21.5 ± 2.6 | 22.0 ± 3.0 | 21.8 ± 3.5 | |||
Driving aaa, bbb, pressure ccc, ddd (cmH20) | ARDSnet eee, fff OLC EIT | 10.7 ± 2.1 | 21.2 ± 2.8 | 19.1 ± 3.9 | 19.1 ± 2.6 | 18.1 ± 3.0 | 18.9 ± 4.8 | 18.1 ± 4.3 | 18.4 ± 3.4 |
20.3 ± 2.2 | 12.6 ± 2.3 | 12.7 ± 2.4 | 11.6 ± 2.2 | 11.2 ± 1.8 | 11.5 ± 1.6 | 11.5 ± 1.6 | |||
23.3 ± 1.6 | 12.6 ± 3.5 | 11.5 ± 3.0 | 12.6 ± 3.3 | 12.3 ± 2.1 | 12.0 ± 2.2 | 12.3 ± 3.0 | |||
Paw-plat aaa, bb, ccc, dd (cmH20) | ARDSnet fff OLC EIT | 16.5 ± 2.1 | 28.1 ± 3.6 | 28.1 ± 4.0 | 27.0 ± 3.4 | 26.3 ± 3.5 | 26.1 ± 3.2 | 27.8 ± 3.8 | 28.0 ± 3.2 |
27.4 ± 3.3 | 32.4 ± 4.6 | 32.7 ± 3.8 | 32.0 ± 3.9 | 31.6 ± 4.0 | 31.1 ± 3.6 | 31.9 ± 3.7 | |||
30.8 ± 3.3 | 33.6 ± 3.5 | 34.8 ± 4.3 | 36.7 ± 3.7 | 36.0 ± 4.0 | 36.1 ± 4.2 | 36.4 ± 5.1 | |||
Paw-peak aaa, ccc (cmH20) | ARDSnet fff, g OLC EIT | 21.1 ± 3.5 | 33.4 ± 3.9 | 37.5 ± 4.3 | 37.4 ± 3.5 | 36.6 ± 2.9 | 36.1 ± 2.9 | 40.5 ± 14.2 | 38.4 ± 5.9 |
33.4 ± 3.9 | 37.5 ± 4.3 | 37.4 ± 3.5 | 36.6 ± 3.0 | 36.1 ± 2.9 | 41.5 ± 14.2 | 38.4 ± 5.9 | |||
37.8 ± 8.3 | 40.3 ± 4.7 | 41.8 ± 4.8 | 43.0 ± 4.1 | 42.5 ± 4.3 | 42.8 ± 4.7 | 44.1 ± 6.9 | |||
PaO2) aaa, bbb, ccc, ddd (mmHg, 100% 02) | ARDSnet eee, fff OLC EIT | 475 ± 70 | 129 ± 64 | 226 ± 100 | 236 ± 112 | 192 ± 98 | 155 ± 64 | 134 ± 58 | 184 ± 95 |
66 ± 18 | 442 ± 64 | 454 ± 79 | 477 ± 40 | 471 ± 38 | 444 ± 42 | 446 ± 31 | |||
77 ± 32 | 507 ± 56 | 502 ± 51 | 500 ± 40 | 466 ± 49 | 430 ± 36 | 422 ± 74 | |||
PaCO2 aaa (mmHg) | ARDSnet OLC EIT | 51.4 ± 9.7 | 58.3 ± 15.0 | 67.3 ± 21.4 | 62.4 ± 10.0 | 58.5 ± 8.5 | 59.9 ± 9.5 | 59.0 ± 8.6 | 62.1 ± 12.1 |
60.2 ± 11.9 | 59.1 ± 9.6 | 54.7 ± 6.3 | 57.1 ± 7.2 | 53.7 ± 6.3 | 55.9 ± 8.7 | 56.4 ± 7.7 | |||
58.5 ± 7.9 | 69.7 ± 10.4 | 67.8 ± 10.2 | 68.4 ± 12.4 | 68.2 ± 16.5 | 65.1 ± 10.4 | 67.3 ± 11 | |||
Compliance aaa, bbb, (mL·cmH2O−1) ccc, dd | ARDSnet eee, ff OLC EIT | 26.5 ± 4.7 | 12.4 ± 2.1 | 11.6 ± 2.1 | 11.4 ± 2.4 | 12.2 ± 2.9 | 12.0 ± 3.6 | 11.93.2 | 11.4 ± 2.3 |
13.6 ± 2. | 19.8 ± 4.1 | 19.7 ± 4.5 | 21.5 ± 7.1 | 21.9 ± 6.7 | 21.9 ± 6.1 | 21.9 ± 5.4 | |||
14.5 ± 4. | 18.7 ± 3.8 | 19.9 ± 4.2 | 18.9 ± 4.0 | 18.8 ± 2.7 | 19.8 ± 3.9 | 18.9 ± 4.1 |
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Haase, J.; Buchloh, D.C.; Hammermüller, S.; Salz, P.; Mrongowius, J.; Carvalho, N.C.; Beda, A.; Rau, A.; Starke, H.; Spieth, P.M.; et al. Mechanical Ventilation Strategies Targeting Different Magnitudes of Collapse and Tidal Recruitment in Porcine Acid Aspiration-Induced Lung Injury. J. Clin. Med. 2019, 8, 1250. https://doi.org/10.3390/jcm8081250
Haase J, Buchloh DC, Hammermüller S, Salz P, Mrongowius J, Carvalho NC, Beda A, Rau A, Starke H, Spieth PM, et al. Mechanical Ventilation Strategies Targeting Different Magnitudes of Collapse and Tidal Recruitment in Porcine Acid Aspiration-Induced Lung Injury. Journal of Clinical Medicine. 2019; 8(8):1250. https://doi.org/10.3390/jcm8081250
Chicago/Turabian StyleHaase, Juliane, Dorina C. Buchloh, Sören Hammermüller, Peter Salz, Julia Mrongowius, Nadja C. Carvalho, Alessandro Beda, Anna Rau, Henning Starke, Peter M. Spieth, and et al. 2019. "Mechanical Ventilation Strategies Targeting Different Magnitudes of Collapse and Tidal Recruitment in Porcine Acid Aspiration-Induced Lung Injury" Journal of Clinical Medicine 8, no. 8: 1250. https://doi.org/10.3390/jcm8081250