Distribution of transpulmonary pressure during one-lung ventilation in pigs at different body positions

Background . Global and regional transpulmonary pressure (P L ) during one-lung ventilation (OLV) is poorly characterized. We hypothesized that global and regional P L and driving P L (ΔP L ) increase during protective low tidal volume OLV compared to two-lung ventilation (TLV), and vary with body p...

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Published in:Frontiers in physiology 2023-08, Vol.14, p.1204531-1204531
Main Authors: Wittenstein, Jakob, Scharffenberg, Martin, Yang, Xiuli, Bluth, Thomas, Kiss, Thomas, Schultz, Marcus J., Rocco, Patricia R. M., Pelosi, Paolo, Gama de Abreu, Marcelo, Huhle, Robert
Format: Article
Language:English
Subjects:
local pleural pressure
local transpulmonary pressure
mechanical power
OLV
Physiology
thoracic surgery
VILI
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Summary:Background . Global and regional transpulmonary pressure (P L ) during one-lung ventilation (OLV) is poorly characterized. We hypothesized that global and regional P L and driving P L (ΔP L ) increase during protective low tidal volume OLV compared to two-lung ventilation (TLV), and vary with body position. Methods . In sixteen anesthetized juvenile pigs, intra-pleural pressure sensors were placed in ventral, dorsal, and caudal zones of the left hemithorax by video-assisted thoracoscopy. A right thoracotomy was performed and lipopolysaccharide administered intravenously to mimic the inflammatory response due to thoracic surgery. Animals were ventilated in a volume-controlled mode with a tidal volume (V T ) of 6 mL kg −1 during TLV and of 5 mL kg −1 during OLV and a positive end-expiratory pressure (PEEP) of 5 cmH 2 O. Global and local transpulmonary pressures were calculated. Lung instability was defined as end-expiratory P L
ISSN:1664-042X
1664-042X
DOI:10.3389/fphys.2023.1204531