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- Title
Lung recruitment assessed by total respiratory system input reactance.
- Authors
Dellaca, Raffaele L.; Olerud, Marie Andersson; Zannin, Emanuela; Kostic, Peter; Pompilio, Pasquale P.; Hedenstierna, Göran; Pedotti, Antonio; Frykholm, Peter
- Abstract
ALI and ARDS are associated with lung volume derecruitment, usually counteracted by PEEP and recruitment maneuvers (RM), which should be accurately tailored to the patient’s needs. The aim of this study was to investigate the possibility of monitoring the amount of derecruited lung by the forced oscillation technique (FOT). We studied six piglets (26 ± 2.5 kg) ventilated by a mechanical ventilator connected to a FOT device that produced sinusoidal pressure forcing at 5 Hz. The percentage of non-aerated lung tissue ( VtissNA%) was measured by whole-body CT scans at end-expiration with zero end-expiratory pressure. Respiratory system oscillatory input reactance ( Xrs) was measured simultaneously to CT and used to derive oscillatory compliance ( CX5), which we used as an index of recruited lung. Measurements were performed at baseline and after several interventions in the following sequence: mono-lateral reabsorption atelectasis, RM, bi-lateral derecruitment induced by broncho-alveolar lavage and a second RM. By pooling data from all experimental conditions and all pigs, CX5 was linearly correlated to VtissNA% ( r2 = 0.89) regardless of the procedure used to de-recruit the lung (reabsorption atelectasis or pulmonary lavage). Separate correlation analysis on single pigs showed similar regression equations, with an even higher coefficient of determination ( r2 = 0.91 ± 0.07). These results suggest that FOT and the measurement of CX5 could be a useful tool for the non-invasive measurement of lung volume recruitment/derecruitment.
- Subjects
LUNG diseases; BRONCHOALVEOLAR lavage; DIAGNOSTIC imaging; RESPIRATORY organs; CRITICAL care medicine
- Publication
Intensive Care Medicine, 2009, Vol 35, Issue 12, p2164
- ISSN
0342-4642
- Publication type
Article
- DOI
10.1007/s00134-009-1673-3