Equal increases in respiratory system elastance reflect similar lung damage in experimental ventilator-induced lung injury

Intensive Care Medicine
Silvio SibillaLuciano Gattinoni

Abstract

We hypothesized that a 50% increase in respiratory system elastance (Ers) would indicate similar degree of lung damage (equi-damage, ED), independently of ventilation strategy. A prospective, randomized animal laboratory investigation at a university hospital laboratory. 35 anesthetized, paralyzed, mechanically ventilated male Sprague-Dawley rats. Each rat was ventilated with a different combination of tidal volume, positive end-expiratory pressure, and inspired fraction of oxygen. Ers was determined throughout the experiment; the studies were interrupted when Ers reached 150% (ED) of its baseline value, or after 5 h. Lung wet to dry weight ratio (W/D) was assessed. Morphological damage of the lung was scored on a grading of perivascular edema, hemorrhage, and breaks in the alveolar septa to obtain a total injury score. Twenty-four rats achieved an Ers of 150%: nine within 1 h (class 1), nine in 1-2 h (class 2), and six in 2-5 h (class 3). Eleven rats did not reach the target 50% increase in Ers (class 4). W/D was higher in rats that reached the target than in those that did not. W/D did not differ among rats that reached ED. Similarly, the total injury score did not differ among classes 1-3 but was higher than class 4. In the ...Continue Reading

Citations

Sep 22, 2007·Intensive Care Medicine·Jérôme Allardet-ServentLaurent Papazian
Apr 20, 2004·Critical Care Medicine·Dana A SimonsonJohn J Marini
Feb 17, 2009·American Journal of Respiratory and Critical Care Medicine·Michael R WilsonMasao Takata
Feb 8, 2011·American Journal of Respiratory and Critical Care Medicine·Alessandro ProttiLuciano Gattinoni
Jun 3, 2005·Intensive Care Medicine·Chiara BonettoV Marco Ranieri
Apr 10, 2012·Respiratory Physiology & Neurobiology·Andrea MoriondoDaniela Negrini
Jan 5, 2011·Critical Care Medicine·Luciano GattinoniEleonora Carlesso
Jun 22, 2017·Thorax·Maurizio CeredaRahim R Rizi
Feb 9, 2018·American Journal of Respiratory and Critical Care Medicine·Yi XinRahim R Rizi
Jun 16, 2007·Journal of Applied Physiology·Andrea MoriondoDaniela Negrini
Jun 15, 2004·American Journal of Physiology. Lung Cellular and Molecular Physiology·Kai HeckelAlwin E Goetz
Jan 9, 2004·American Journal of Physiology. Lung Cellular and Molecular Physiology·James C Parker, Mary I Townsley

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