Progression of regional lung strain and heterogeneity in lung injury: assessing the evolution under spontaneous breathing and mechanical ventilation
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Fecha
2020-12
Profesor/a Guía
Facultad/escuela
Idioma
en
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Editor
Springer
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Licencia CC
Atribution 4.0 International (CC BY 4.0)
Licencia CC
https://creativecommons.org/licenses/by/4.0/deed.es
Resumen
Background: Protective mechanical ventilation (MV) aims at limiting global lung deformation and has been associ‑
ated with better clinical outcomes in acute respiratory distress syndrome (ARDS) patients. In ARDS lungs without MV
support, the mechanisms and evolution of lung tissue deformation remain understudied. In this work, we quantify
the progression and heterogeneity of regional strain in injured lungs under spontaneous breathing and under MV.
Methods: Lung injury was induced by lung lavage in murine subjects, followed by 3 h of spontaneous breathing
(SB-group) or 3 h of low Vt
mechanical ventilation (MV-group). Micro-CT images were acquired in all subjects at the
beginning and at the end of the ventilation stage following induction of lung injury. Regional strain, strain progres‑
sion and strain heterogeneity were computed from image-based biomechanical analysis. Three-dimensional regional
strain maps were constructed, from which a region-of-interest (ROI) analysis was performed for the regional strain, the
strain progression, and the strain heterogeneity.
Results: After 3 h of ventilation, regional strain levels were signifcantly higher in 43.7% of the ROIs in the SB-group.
Signifcant increase in regional strain was found in 1.2% of the ROIs in the MV-group. Progression of regional strain
was found in 100% of the ROIs in the SB-group, whereas the MV-group displayed strain progression in 1.2% of the
ROIs. Progression in regional strain heterogeneity was found in 23.4% of the ROIs in the SB-group, while the MV-group
resulted in 4.7% of the ROIs showing signifcant changes. Deformation progression is concurrent with an increase of
non-aerated compartment in SB-group (from 13.3%±1.6% to 37.5%±3.1%), being higher in ventral regions of the
lung.
Conclusions: Spontaneous breathing in lung injury promotes regional strain and strain heterogeneity progression. In
contrast, low Vt
MV prevents regional strain and heterogeneity progression in injured lungs.
Notas
Indexación: Scopus.
Palabras clave
Acute Lung Injury, Spontaneous Breathing, Mechanical Ventilation, Lung Strain, Lung Heterogeneity, Image-Based Biomechanical Analysis
Citación
Annals of Intensive Care. Volume 10, Issue 11 December 2020 Article number 107
DOI
10.1186/s13613-020-00725-0