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Validating the insp...
Validating the inspired sinewave technique to measure the volume of the 'baby lung' in a porcine lung-injury model
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- Crockett, Douglas C. (author)
- Univ Oxford, Nuffield Div Anaesthet, Oxford, England
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- Tran, Minh C. (author)
- Univ Oxford, Nuffield Div Anaesthet, Oxford, England;Univ Oxford, Dept Engn Sci, Oxford, England
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- Formenti, Federico (author)
- Univ Oxford, Nuffield Div Anaesthet, Oxford, England;Kings Coll London, Ctr Human & Appl Physiol Sci, London, England;Univ Nebraska, Dept Biomech, Omaha, NE 68182 USA
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- Cronin, John N. (author)
- Kings Coll London, Ctr Human & Appl Physiol Sci, London, England
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- Hedenstierna, Göran, 1941- (author)
- Uppsala universitet,Klinisk fysiologi,Hedenstiernalaboratoriet
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- Larsson, Anders (author)
- Uppsala universitet,Anestesiologi och intensivvård
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- Phan, Phi A. (author)
- Univ Oxford, Nuffield Div Anaesthet, Oxford, England
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- Farmery, Andrew D. (author)
- Univ Oxford, Nuffield Div Anaesthet, Oxford, England
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(creator_code:org_t)
- ELSEVIER SCI LTD, 2020
- 2020
- English.
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In: British Journal of Anaesthesia. - : ELSEVIER SCI LTD. - 0007-0912 .- 1471-6771. ; 124:3, s. 345-353
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Abstract
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- Background: Bedside lung volume measurement could personalise ventilation and reduce driving pressure in patients with acute respiratory distress syndrome (ARDS). We investigated a modified gas-dilution method, the inspired sinewave technique (IST), to measure the effective lung volume (ELV) in pigs with uninjured lungs and in an ARDS model. Methods: Anaesthetised mechanically ventilated pigs were studied before and after surfactant depletion by saline lavage. Changes in PEEP were used to change ELV. Paired measurements of absolute ELV were taken with IST (ELVIST) and compared with gold-standard measures (sulphur hexafluoride wash in/washout [ELVSF6] and computed tomography (CT) [ELVCT]). Measured volumes were used to calculate changes in ELV (Delta ELV) between PEEP levels for each method (Delta ELVIST, Delta ELVSF6, and Delta ELVCT). Results: The coefficient of variation was <5% for repeated ELVIST measurements (n=13 pigs). There was a strong linear relationship between ELVIST and ELVSF6 in uninjured lungs (r(2)=0.97), and with both ELVSF6 and ELVCT in the ARDS model (r(2)=0.87 and 0.92, respectively). ELVIST had a mean bias of -12 to 13% (95% limits=+/- 17 - 25%) compared with ELVSF6 and ELVCT. Delta ELVIST was concordant with Delta ELVSF6 and Delta ELVCT in 98-100% of measurements, and had a mean bias of -73 to -77 ml (95% limits=+/- 128 - 186 ml) compared with Delta ELVSF6 and -1 ml (95% limits +/- 333 ml) compared with Delta ELVCT. Conclusions: IST provides a repeatable measure of absolute ELV and shows minimal bias when tracking PEEP-induced changes in lung volume compared with CT in a saline-lavage model of ARDS.
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
- ARDS
- computed tomography
- inspired sinewave technique
- lung volume measurement
- method comparison
Publication and Content Type
- ref (subject category)
- art (subject category)
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