Lung heterogeneity and deadspace volume in acute respiratory distress syndrome animals using the inspired sinewave test

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Tran, Minh CongNuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom; The Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom (author)

Lung heterogeneity and deadspace volume in acute respiratory distress syndrome animals using the inspired sinewave test

Article/chapterEnglish2020

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2020-12-09
IOP Publishing,2020
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LIBRIS-ID:oai:DiVA.org:uu-433170
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-433170URI
https://doi.org/10.1088/1361-6579/abc0b5DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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The acute respiratory distress syndrome is associated with a high rate of morbidity and mortality, as patients undergoing mechanical ventilation are at risk of ventilator-induced lung injuries.OBJECTIVE: To measure the lung heterogeneity and deadspace volume to find safer ventilator strategies. Then, the ventilator settings could offer homogeneous ventilation and theoretically equalise and reduce tidal strain/stress in the lung parenchyma.APPROACH: The Inspired Sinewave Test (IST) is a non-invasive lung measurement tool, which does not require patients' cooperation. The IST can measure the effective lung volume, pulmonary blood flow and deadspace volume. We developed a computational simulation of the cardiopulmonary system to allow lung heterogeneity to be quantified using data solely derived from the IST. Then, the method to quantify lung heterogeneity using two IST tracer gas frequencies (180s and 60s) was introduced and experimented in the simulation lungs and in animal models. Thirteen anaesthetised pigs were studied with the IST, both before and after experimental lung injury (saline-lavage ARDS model). The deadspace volume is compared between IST and the SF_{6} Washout method.RESULTS: The IST could measure the lung heterogeneity using two frequencies tracer gases. Furthermore, the value of IST ventilation heterogeneity in ARDS lungs were higher than in control lungs at PEEP 10cmH_{2}O (AuC=0.85, p<0.001). Deadspace volume values measured by the IST has a strong relationship with the measured values of the SF_{6} (9mL bias and limits of agreement from -79mL to 57mL in control animals).SIGNIFICANCE: the potential impact of the IST technique in the identification of ventilation and perfusion heterogeneity during ventilator support.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
ARDS
IST
Inspired Sinewave Test
Lung Simulation
Lung heterogeneity
Anestesiologi och intensivvård
Anaesthesiology and Intensive Care
Fysiologi
Physiology

Added entries (persons, corporate bodies, meetings, titles ...)

Crockett, Douglas CNuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom (author)
Formenti, FedericoCentre for Human and Applied Physiological Sciences, King' s College London, London, United Kingdom (author)
Phan, Phi AnhNuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom (author)
Hedenstierna, Göran,1941-Uppsala universitet,Hedenstiernalaboratoriet(Swepub:uu)goranhed (author)
Larsson, AndersUppsala universitet,Hedenstiernalaboratoriet(Swepub:uu)andla606 (author)
Payne, Stephen JThe Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom (author)
Farmery, Andrew DNuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom (author)
Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom; The Institute of Biomedical Engineering, University of Oxford, Oxford, United KingdomNuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom (creator_code:org_t)

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In:Physiological Measurement: IOP Publishing41:110967-33341361-6579

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By the author/editor: Tran, Minh Cong; Crockett, Dougla ...; Formenti, Federi ...; Phan, Phi Anh; Hedenstierna, Gö ...; Larsson, Anders; show more...; Payne, Stephen J; Farmery, Andrew ...; show less...

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