Data di Pubblicazione:
2012
Citazione:
Time-course of experimental ventilator-induced lung injury : a CT scan study / M.T. Cressoni Mainoni, C. Chiurazzi, M. Amini, M. Brioni, E. Gallazzi, A. Marino, M. Chierichetti, D. Febres, P. Cadringher, R. Giuliano, D. Zani, C. Mocchi, M. Di Giancamillo, L. Gattinoni. ((Intervento presentato al 23. convegno SMART : Simposio Mostra Anestesia Rianimazione e Terapia Intensiva tenutosi a Milano nel 2012.
Abstract:
Introduction
High volumes/pressures induce lung lesions indistinguishable from ALI/ARDS.
Objective
We wished to investigate time course of experimental lung injury with CT scan.
Methods
Two piglets (25 kg) were ventilated with a level of strain (TV/FRC) of 3 (~44 ml/Kg), which is known to induce experimental Ventilator-Induced Lung Injury. Blood gases, lung mechanics and CT scan data were acquired every 3 hours or when needed. Quantitative lung CT scan analysis was performed to compute lung weight and edema. We also derived the amount of intra-tidal opening and closing.
Discussion
Table 1 shows the main physiological variables during the course of the study. The quantity of tissue opening and closing tended to increase during the course of experiment with the worsening of clinical conditions (Opening and closing tissue(g)=474±221*PaO2/FiO2,r2=0.96). The development of edema was related to an increase in overall lung volume (lung volume increase(ml)=98±0.62*Lung edema(g),r2=0.62) without a corresponding decrease in FRC.
Conclusions
VILI, once initiated, proceeds rapidly, leading to widespread lung damage. The development of anatomical lung damage observable at CT scan preceded the impairment of mechanics and gas exchange. We may speculate that the application of PEEP could reduce the opening and closing fraction and the increase in global strain due to lung collapse, delaying the progression of VILI.
Tipologia IRIS:
14 - Intervento a convegno non pubblicato
Elenco autori:
M.T. Cressoni Mainoni, C. Chiurazzi, M. Amini, M. Brioni, E. Gallazzi, A. Marino, M. Chierichetti, D. Febres, P. Cadringher, R. Giuliano, D. Zani, C. Mocchi, M. Di Giancamillo, L. Gattinoni
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