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Open AccessArticle

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

1
Department of Morphology, Surgery and Experimental Medicine, Ferrara University, 44121 Ferrara, Italy
2
Hedenstierna Laboratory, Department of Surgical Sciences, Uppsala University, 75185 Uppsala, Sweden
3
Department of Anesthesia and Intensive Care, Uppsala University Hospital, 75185 Uppsala, Sweden
4
Department of Physics, University of Helsinki, FI-00014 Helsinki, Finland
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Helsinki University Hospital, FI-00029 Helsinki, Finland
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Department of Emergency and Organ Transplant, Bari University, 70124 Bari, Italy
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Centre for Human and Applied Physiological Sciences, Faculty of Sciences and Medicine, King’s College, London WC2R 2LS, UK
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The European Synchrotron Radiation Facility, 38043 Grenoble, France
9
INSERM UA7, Synchrotron Radiation for Biomedicine (STROBE) Laboratory, University of Grenoble Alpes, 38043 Grenoble, France
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(8), 1117; https://doi.org/10.3390/jcm8081117
Received: 25 June 2019 / Revised: 17 July 2019 / Accepted: 25 July 2019 / Published: 28 July 2019
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 cmH2O. 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. View Full-Text
Keywords: ARDS; recruitment; VILI; alveoli; kinetics; synchrotron radiation computed tomography ARDS; recruitment; VILI; alveoli; kinetics; synchrotron radiation computed tomography
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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. The Effect of Positive End-Expiratory Pressure on Lung Micromechanics Assessed by Synchrotron Radiation Computed Tomography in an Animal Model of ARDS. J. Clin. Med. 2019, 8, 1117.

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