Endexpiratory lung volume measurement correlates with the ventilation/perfusion mismatch in lung injured pigs

• Published in: Respiratory research 2017-05, Vol.18 (1), p.101-101, Article 101
• Main Authors: Kamuf, Jens, Garcia-Bardon, Andreas, Duenges, Bastian, Liu, Tanghua, Jahn-Eimermacher, Antje, Heid, Florian, David, Matthias, Hartmann, Erik K
• Format: Article
• Language: English
• Subjects: Adult respiratory distress syndrome; Alveoli; Animal models; Animals; ARDS; Bronchus; Care and treatment; Coefficients; Correlation analysis; Correlation coefficient; Diagnosis; Electric power distribution; Electrical impedance; Endexpiratory lung volume; Exchanging; Forced Expiratory Volume - physiology; Gas exchange; Gases; Impedance; Injection; Injuries; Intensive care; Laboratory animals; Lung Injury - physiopathology; Lung volume measurement; Lung Volume Measurements - methods; Lungs; Male; Mathematical models; Mechanical ventilation; Nitrogen; Oleic acid; Patient outcomes; Patients; Peak Expiratory Flow Rate - physiology; Perfusion; Pig model; Pressure; Pulmonary Ventilation - physiology; Rare gases; Recruitment; Regression coefficients; Respiratory distress syndrome; Respiratory Distress Syndrome, Adult - physiopathology; Respiratory function; Respiratory therapy; Swine; Technology assessment; Tidal energy; Tidal power; Tomography; Ventilation; Ventilation/perfusion mismatch; Volume measurement
• ISSN: 1465-993X; 1465-9921; 1465-993X; 1465-9921
• DOI: 10.1186/s12931-017-0585-y

In acute respiratory respiratory distress syndrome (ARDS) a sustained mismatch of alveolar ventilation and perfusion (V /Q) impairs the pulmonary gas exchange. Measurement of endexpiratory lung volume (EELV) by multiple breath-nitrogen washout/washin is a non-invasive, bedside technology to assess pulmonary function in mechanically ventilated patients. The present study examines the association between EELV changes and V /Q distribution and the possibility to predict V /Q normalization by means of EELV in a porcine model. After approval of the state and institutional animal care committee 12 anesthetized pigs were randomized to ARDS either by bronchoalveolar lavage (n = 6) or oleic acid injection (n = 6). EELV, V /Q ratios by multiple inert gas elimination and ventilation distribution by electrical impedance tomography were assessed at healthy state and at five different positive endexpiratory pressure (PEEP) steps in ARDS (0, 20, 15, 10, 5 cmH O; each maintained for 30 min). V /Q, EELV and tidal volume distribution all displayed the PEEP-induced recruitment in ARDS. We found a close correlation between V /Q