Intra-tidal PaO2 oscillations associated with mechanical ventilation: a pilot study to identify discrete morphologies in a porcine model

↓ Direkt till sidans innehåll
↓ Direkt till sidans sekundära innehåll (sidomenyn)

Search: onr:"swepub:oai:DiVA.org:uu-512198" > Intra-tidal PaO2 os...

1 of 1
Previous record
Next record
To hitlist

Intra-tidal PaO2 oscillations associated with mechanical ventilation : a pilot study to identify discrete morphologies in a porcine model

Cronin, John N. (author): Guys & St Thomas NHS Fdn Trust, St Thomas Hosp, Dept Anaesthesia & Perioperat Med, Westminster Bridge Rd, London SE1 7EH, England.;Kings Coll London, Fac Life Sci & Med, London, England.

Crockett, Douglas C. (author): Univ Oxford, Nuffield Dept Clin Neurosci, Oxford, England.

Perchiazzi, Gaetano (author): Uppsala universitet,Institutionen för kirurgiska vetenskaper

Farmery, Andrew D. (author): Univ Oxford, Nuffield Dept Clin Neurosci, Oxford, England.

Camporota, Luigi (author): Kings Coll London, Fac Life Sci & Med, London, England.;Guys & St Thomas NHS Fdn Trust, Dept Intens Care, London, England.

Formenti, Federico (author): Kings Coll London, Fac Life Sci & Med, London, England.;Univ Oxford, Nuffield Dept Clin Neurosci, Oxford, England.

show less...

Guys & St Thomas NHS Fdn Trust, St Thomas Hosp, Dept Anaesthesia & Perioperat Med, Westminster Bridge Rd, London SE1 7EH, England;Kings Coll London, Fac Life Sci & Med, London, England. Univ Oxford, Nuffield Dept Clin Neurosci, Oxford, England. (creator_code:org_t)

Springer Nature, 2023
2023
English.
In: Intensive Care Medicine Experimental. - : Springer Nature. - 2197-425X. ; 11:1

Related links:: https://doi.org/10.1...; show more...; https://uu.diva-port... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Background: Within-breath oscillations in arterial oxygen tension (PaO2) can be detected using fast responding intra-arterial oxygen sensors in animal models. These PaO2 signals, which rise in inspiration and fall in expiration, may represent cyclical recruitment/derecruitment and, therefore, a potential clinical monitor to allow titration of ventilator settings in lung injury. However, in hypovolaemia models, these oscillations have the potential to become inverted, such that they decline, rather than rise, in inspiration. This inversion suggests multiple aetiologies may underlie these oscillations. A correct interpretation of the various PaO2 oscillation morphologies is essential to translate this signal into a monitoring tool for clinical practice. We present a pilot study to demonstrate the feasibility of a new analysis method to identify these morphologies.Methods Seven domestic pigs (average weight 31.1 kg) were studied under general anaesthesia with muscle relaxation and mechanical ventilation. Three underwent saline-lavage lung injury and four were uninjured. Variations in PEEP, tidal volume and presence/absence of lung injury were used to induce different morphologies of PaO2 oscillation. Functional principal component analysis and k-means clustering were employed to separate PaO2 oscillations into distinct morphologies, and the cardiorespiratory physiology associated with these PaO2 morphologies was compared.Results PaO2 oscillations from 73 ventilatory conditions were included. Five functional principal components were sufficient to explain = 95% of the variance of the recorded PaO2 signals. From these, five unique morphologies of PaO2 oscillation were identified, ranging from those which increased in inspiration and decreased in expiration, through to those which decreased in inspiration and increased in expiration. This progression was associated with the estimates of the first functional principal component (P < 0.001, R-2 = 0.88). Intermediate morphologies demonstrated waveforms with two peaks and troughs per breath. The progression towards inverted oscillations was associated with increased pulse pressure variation (P = 0.03).Conclusions Functional principal component analysis and k-means clustering are appropriate to identify unique morphologies of PaO2 waveform associated with distinct cardiorespiratory physiology. We demonstrated novel intermediate morphologies of PaO2 waveform, which may represent a development of zone 2 physiologies within the lung. Future studies of PaO2 oscillations and modelling should aim to understand the aetiologies of these morphologies.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)

Keyword

Acute respiratory distress syndrome
Mechanical ventilation
Arterial oxygen tension
Oxygen oscillations
Functional principal component analysis

Publication and Content Type

ref (subject category)
art (subject category)

Find in a library

Intensive Care Medicine Experimental (Search for host publication in LIBRIS)

To the university's database

1 of 1
Previous record
Next record
To hitlist

Find more in SwePub

By the author/editor: Cronin, John N.; Crockett, Dougla ...; Perchiazzi, Gaet ...; Farmery, Andrew ...; Camporota, Luigi; Formenti, Federi ...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

Articles in the publication: Intensive Care M ...

By the university: Uppsala University

Search outside SwePub

Extend your search to:: Google; Google Book Search; Google Scholar

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se