Source: Annual Congress 2010 - State of the art imaging
Disease area: Respiratory critical care

Abstract

We assessed the heterogeneity of regional lung ventilation (CV of sV) using Xe-enhanced synchrotron imaging at baseline at PEEP 3 and 9 cmH₂O. Forced oscillations were used to measure airway resistance (Raw), respiratory tissue damping (G) and elastance (H). The area of underaerated (UA) and overdistended (OD) zones were estimated based on lung tissue density. Measurements were repeated following whole lung lavage-induced surfactant depletion (LL, 20 ml/kg) with subsequent application of PEEP 3, 9, then 3 cmH₂O again.

	Baseline		Lavage-Induced Injury
PEEP (cmH2O)	3	9	3	9	3
G (cmH2O/l)	120.1±12.8	120.7±15.8	173.9±64.1	131.4±21.9	195.7±72.2*§
H (cmH2O/l)	485±110	546±47	723±235	542±45	819±316*
UA (%)	3.1±1.1	1.8±0.6	31.7±15.1*	3.5±2.3#	10.8±11.5
OD (%)	4.5±2.6	16.6±2.6*	1.1±2.1*	4.7±5.6#	6.2±15.4#

*: p<0.05 vs. baseline PEEP3; #: p<0.05 vs. LL-PEEP3; §: p<0.05 vs. LL-PEEP9, one way RM-ANOVA.

LL significantly increased CV and the UA. CV and the UA were lower on PEEP 9, as were G and H. CV significantly correlated with G and H (R=0.72 and 0.75 respectively, p<0.0001 for both). These results suggest that a moderate PEEP of 9 cmH₂O improves ventilation heterogeneity with minimal lung overdistension in the present model of lung injury.

Supported by SNSF grant 3200B0-118231, the Academy of Finland and the ESRF.

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S. Bayat, L. Porra, G. Albu, H. Suhonen, S. Strengell, P. Suortti, A. R. A. Sovijärvi, W. Habre (Amiens, Grenoble, France; Helsinki, Finland; Geneva, Switzerland). Moderate PEEP improves ventilation heterogeneity with minimal overdistension in lavage-induced surfactant depletion in rabbits: A synchrotron imaging study. Eur Respir J 2010; 36: Suppl. 54, 5283

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