Document Type

Article

Language

eng

Format of Original

9 p.

Publication Date

10-15-2007

Publisher

American Thoracic Society

Source Publication

American Journal of Respiratory and Critical Care Medicine

Source ISSN

1073-449X

Original Item ID

doi: 10.1164/rccm.200701-088OC

Abstract

Rationale: Mechanical ventilation with large tidal volumes causes ventilator-induced lung injury in animal models. Little direct evidence exists regarding the deformation of airways in vivo during mechanical ventilation, or in the presence of positive end-expiratory pressure (PEEP).

Objectives: To measure airway strain and to estimate airway wall tension during mechanical ventilation in an intact animal model.

Methods: Sprague-Dawley rats were anesthetized and mechanically ventilated with tidal volumes of 6, 12, and 25 cm3/kg with and without 10–cm H2O PEEP. Real-time tantalum bronchograms were obtained for each condition, using microfocal X-ray imaging. Images were used to calculate circumferential and longitudinal airway strains, and on the basis of a simplified mathematical model we estimated airway wall tensions.

Measurements and Main Results: Circumferential and longitudinal airway strains increased with increasing tidal volume. Levels of mechanical strain were heterogeneous throughout the bronchial tree. Circumferential strains were higher in smaller airways (less than 800 μm). Airway size did not influence longitudinal strain. When PEEP was applied, wall tensions increased more rapidly than did strain levels, suggesting that a “strain limit” had been reached. Airway collapse was not observed under any experimental condition.

Conclusions: Mechanical ventilation results in significant airway mechanical strain that is heterogeneously distributed in the uninjured lung. The magnitude of circumferential but not axial strain varies with airway diameter. Airways exhibit a “strain limit” above which an abrupt dramatic rise in wall tension is observed.

Comments

Published version. American Journal of Respiratory and Critical Care Medicine, Vol. 176, No. 8 (October 15, 2007): 786-794. DOI. © American Thoraic Society 2007. Used with permission.

Share

COinS