Document Detail


Linking the development of ventilator-induced injury to mechanical function in the lung.
MedLine Citation:
PMID:  23161164     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Management of ALI/ARDS involves supportive ventilation at low tidal volumes (V t) to minimize the rate at which ventilator induced lung injury (VILI) develops while the lungs heal. However, we currently have few details to guide the minimization of VILI in the ALI/ARDS patient. The goal of the present study was to determine how VILI progresses with time as a function of the manner in which the lung is ventilated in mice. We found that the progression of VILI caused by over-ventilating the lung at a positive end-expiratory pressure of zero is accompanied by progressive increases in lung stiffness as well as the rate at which the lung derecruits over time. We were able to accurately recapitulate these findings in a computational model that attributes changes in the dynamics of recruitment and derecruitment to two populations of lung units. One population closes over a time scale of minutes following a recruitment maneuver and the second closes in a matter of seconds or less, with the relative sizes of the two populations changing as VILI develops. This computational model serves as a basis from which to link the progression of VILI to changes in lung mechanical function.
Authors:
Bradford J Smith; Kara A Grant; Jason H T Bates
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2012-11-16
Journal Detail:
Title:  Annals of biomedical engineering     Volume:  41     ISSN:  1573-9686     ISO Abbreviation:  Ann Biomed Eng     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-15     Completed Date:  2013-09-06     Revised Date:  2014-08-04    
Medline Journal Info:
Nlm Unique ID:  0361512     Medline TA:  Ann Biomed Eng     Country:  United States    
Other Details:
Languages:  eng     Pagination:  527-36     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Lung Injury / physiopathology,  therapy
Animals
Biomechanical Phenomena
Biomedical Engineering
Computer Simulation
Disease Models, Animal
Elasticity / physiology
Humans
Mice
Mice, Inbred BALB C
Models, Biological
Positive-Pressure Respiration / adverse effects,  methods
Respiratory Distress Syndrome, Adult / physiopathology,  therapy
Respiratory Mechanics
Tidal Volume / physiology
Ventilator-Induced Lung Injury / etiology,  physiopathology*,  prevention & control
Grant Support
ID/Acronym/Agency:
P30 GM103532/GM/NIGMS NIH HHS; P30 GM103532/GM/NIGMS NIH HHS; T32 HL076122/HL/NHLBI NIH HHS; T32 HL076122/HL/NHLBI NIH HHS
Comments/Corrections

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