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Alveolar Tidal recruitment/derecruitment and Overdistension During Four Levels of End-Expiratory Pressure with Protective Tidal Volume During Anesthesia in a Murine Lung-Healthy Model

  • Respiratory Mechanics
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Abstract

Purpose

We compared respiratory mechanics between the positive end-expiratory pressure of minimal respiratory system elastance (PEEPminErs) and three levels of PEEP during low-tidal-volume (6 mL/kg) ventilation in rats.

Methods

Twenty-four rats were anesthetized, paralyzed, and mechanically ventilated. Airway pressure (Paw), flow (F), and volume (V) were fitted by a linear single compartment model (LSCM) Paw(t) = Ers × V(t) + Rrs × F(t) + PEEP or a volume- and flow-dependent SCM (VFDSCM) Paw(t) = (E1 + E2 × V(t)) × V(t) + (K1 + K2 × |F(t)|) × F(t) + PEEP, where Ers and Rrs are respiratory system elastance and resistance, respectively; E1 and E2× V are volume-independent and volume-dependent Ers, respectively; and K1 and K2 × F are flow-independent and flow-dependent Rrs, respectively. Animals were ventilated for 1 h at PEEP 0 cmH2O (ZEEP); PEEPminErs; 2 cmH2O above PEEPminErs (PEEPminErs+2); or 4 cmH2O above PEEPminErs (PEEPminErs+4). Alveolar tidal recruitment/derecruitment and overdistension were assessed by the index %E2 = 100 × [(E2 × VT)/(E1 + |E2| × VT)], and alveolar stability by the slope of Ers(t).

Results

%E2 varied between 0 and 30% at PEEPminErs in most respiratory cycles. Alveolar Tidal recruitment/derecruitment (%E2 < 0) and overdistension (%E2 > 30) were predominant in the absence of PEEP and in PEEP levels higher than PEEPminErs, respectively. The slope of Ers(t) was different from zero in all groups besides PEEPminErs+4.

Conclusions

PEEPminErs presented the best compromise between alveolar tidal recruitment/derecruitment and overdistension, during 1 h of low-VT mechanical ventilation.

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Funding

This study was supported by grants from the Brazilian Council for Scientific and Technology Development (CNPq)—140047/2008-5.

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Author notes

  1. Joao Henrique Neves Soares

    Present address: Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, 24061, USA

Authors and Affiliations

  1. Laboratory of Pulmonary Engineering, Biomedical Engineering Program/COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, 22210-03, Brazil

    Joao Henrique Neves Soares, Alysson Roncally Carvalho, Bruno Curty Bergamini, Frederico Caetano Jandre & Antonio Giannella-Neto

  2. Laboratory of Respiration Physiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, 22210-03, Brazil

    Alysson Roncally Carvalho & Walter Araujo Zin

  3. Laboratory of Animal Research, Veterinary School, Fluminense Federal University, Niteroi, RJ, 24320-340, Brazil

    Maria Alice Kuster Gress

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Correspondence to Joao Henrique Neves Soares.

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Ethical Approval

All procedures performed in this study were in compliance with the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research and the “Guiding Principles in the Care and Use of Animals” approved by the Council of the American Physiological Society, USA. The present study was approved by the Institutional Animal Care and Use Committee (CEUA CCS, IBCCF-019).

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Soares, J.H.N., Carvalho, A.R., Bergamini, B.C. et al. Alveolar Tidal recruitment/derecruitment and Overdistension During Four Levels of End-Expiratory Pressure with Protective Tidal Volume During Anesthesia in a Murine Lung-Healthy Model. Lung 196, 335–342 (2018). https://doi.org/10.1007/s00408-018-0096-8

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