| Regional lung volume changes during high-frequency oscillatory ventilation. | |
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MedLine Citation:
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PMID: 20595820 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate regional lung volume changes occurring during an inflation-deflation maneuver using high-frequency oscillatory ventilation. DESIGN: Prospective animal trial. SETTING: Animal research laboratory. SUBJECTS: Six Yorkshire swine. INTERVENTIONS: Electrical impedance tomography was used to quantify regional ventilation during high-frequency oscillatory ventilation. The electrical impedance tomography-derived center of ventilation was used to describe the distribution of regional ventilation, whereas spectral analysis was used to describe regional ventilation-induced impedance changes. Lung injury was induced using surfactant lavage. Animals were transitioned to high-frequency oscillatory ventilation and a slow inflation-deflation maneuver was performed by changing mean airway pressure by 5 cm H2O every 15 mins to a maximum mean airway pressure of 40 cm H2O. MEASUREMENTS AND MAIN RESULTS: The induction of lung injury was associated with a significant shift of the center of ventilation toward nondependent areas and an increase in shunt fraction (p < .001). During the following inflation-deflation maneuver using high-frequency oscillatory ventilation, inflation was associated with a shift of the center of ventilation from nondependent to dependent areas. Center of ventilation was significantly correlated with the shunt fraction (p < .001). Analyzing different lung layers along the gravitational axis separately, nondependent lung areas showed significantly decreased regional ventilation-induced impedance changes at higher pressures, suggesting overdistension, whereas dependent lung areas showed increased impedance changes, suggesting recruitment. The reverse was observed during deflation (all p < .05). CONCLUSIONS: The center of ventilation during high-frequency oscillatory ventilation correlated with oxygenating efficiency as measured by the shunt fraction. Lung recruitment during high-frequency oscillatory ventilation produced a significant shift of regional ventilation toward dependent areas of the lung and led to overdistension of nondependent areas. |
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Authors:
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Gerhard K Wolf; Bartłomiej Grychtol; Inez Frerichs; David Zurakowski; John H Arnold |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies Volume: 11 ISSN: 1529-7535 ISO Abbreviation: Pediatr Crit Care Med Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-08 Completed Date: 2011-01-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100954653 Medline TA: Pediatr Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 610-5 Citation Subset: IM |
Affiliation:
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Division of Critical Care Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA. gerhard.wolf@childrens.harvard.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Disease Models, Animal Electric Impedance High-Frequency Ventilation* Lung Volume Measurements Swine Tomography Ventilator-Induced Lung Injury / physiopathology* |
| Comments/Corrections | |
Comment In:
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Pediatr Crit Care Med. 2010 Sep;11(5):639-40
[PMID:
20823742
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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