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Volume 2 Supplement 1

ESICM LIVES 2014

0990. Role of amplitude and rate of deformation in ventilator-induced lung injury

Introduction

Increasing both Tidal Volume (VT) (amplitude of lung deformation) and Inspiratory Flow (V') (rate of lung deformation) augments incidence of Ventilator-Induced Lung Injury (VILI) [1].

Objectives

To clarify whether increasing V' at constant VT augments incidence of VILI.

Methods

Twenty-eight healthy piglets were mechanically ventilated for up to 54 hours. Each animal was assigned to one of three groups of VT (300-400 ml; 500-600 ml; 750 ml) and one of two groups of V'. Lower and higher V' were obtained by setting inspiratory-to-expiratory time ratio as high as 1:2 or as low as 1:9. Respiratory rate was always 15 breaths per minute. Interplay between VT and V' was assessed at the beginning of the study as airway pressure-volume loop area (or dynamic respiratory system hysteresis). VILI was defined as pulmonary oedema (lung weight gain ≥10% across the study period).

Results

Main findings are reported in Table 1.

Table 1 Inspiratory flow and incidence of VILI

Conclusions

Increasing V' (rate of lung deformation) while maintaining VT (amplitude of lung deformation) constant augments incidence of VILI. Further studies are needed to clarify whether dynamic respiratory system hysteresis is an independent predictor of VILI.

References

  1. 1.

    Protti A, et al.: Lung stress and strain during mechanical ventilation: any safe threshold? Am J Respir Crit Care Med 2011, 183: 1354–1362. 10.1164/rccm.201010-1757OC

    PubMed  Article  Google Scholar 

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Grant acknowledgment

This study was supported in part by an Italian grant provided by Fondazione Fiera di Milano for Translational and Competitive Research (2007, Luciano Gattinoni) and by GE Healthcare.

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Correspondence to A Protti.

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Protti, A., Andreis, D., Milesi, M. et al. 0990. Role of amplitude and rate of deformation in ventilator-induced lung injury. ICMx 2, P75 (2014). https://doi.org/10.1186/2197-425X-2-S1-P75

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Keywords

  • Public Health
  • Weight Gain
  • Respiratory Rate
  • Independent Predictor
  • Lung Injury