Progression of regional lung strain and heterogeneity in lung injury: assessing the evolution under spontaneous breathing and mechanical ventilation

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dc.contributor.authorHurtado Sepúlveda, Daniel
dc.contributor.authorSarabia Vallejos, Mauricio
dc.contributor.authorIturrieta, Pablo
dc.contributor.authorErranz, Benjamín
dc.contributor.authorLillo, Felipe
dc.contributor.authorMorales, Felipe
dc.contributor.authorBlaha, Katherine
dc.contributor.authorMedina, Tania
dc.contributor.authorDiaz, Franco
dc.contributor.authorCruces, Pablo
dc.date.accessioned2020-08-11T11:28:44Z
dc.date.available2020-08-11T11:28:44Z
dc.date.issued2020
dc.date.updated2020-08-09T00:02:26Z
dc.description.abstractAbstract Background Protective mechanical ventilation (MV) aims at limiting global lung deformation and has been associated 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 progression 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 significantly higher in 43.7% of the ROIs in the SB-group. Significant 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 significant 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.
dc.identifier.citationAnnals of Intensive Care. 2020 Aug 06;10(1):107
dc.identifier.doi10.1186/s13613-020-00725-0
dc.identifier.urihttps://doi.org/10.1186/s13613-020-00725-0
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/38492
dc.issue.numeroNo. 107
dc.language.isoen
dc.pagina.final10
dc.pagina.inicio1
dc.revistaAnnals of Intensive Carees_ES
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.subjectAcute lung injuryes_ES
dc.subjectSpontaneous breathinges_ES
dc.subjectMechanical ventilationes_ES
dc.subjectLung straines_ES
dc.subjectLung heterogeneityes_ES
dc.subjectImage-based biomechanical analysises_ES
dc.subject.ddc616.24
dc.subject.deweyMedicina y saludes_ES
dc.titleProgression of regional lung strain and heterogeneity in lung injury: assessing the evolution under spontaneous breathing and mechanical ventilationes_ES
dc.typeartículo
dc.volumenVol. 10
sipa.codpersvinculados3569
sipa.codpersvinculados170370
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