The role of high airway pressure and dynamic strain on ventilator-induced lung injury in a heterogeneous acute lung injury model

Jain, Sumeet V.; Kollisch-Singule, Michaela; Satalin, Joshua; Searles, Quinn; Dombert, Luke; Abdel-Razek, Osama; Yepuri, Natesh; Leonard, Antony; Gruessner, Angelika; Andrews, Penny; Fazal, Fabeha; Meng, Qinghe; Wang, Guirong; Gatto, Louis A.; Habashi, Nader M.; Nieman, Gary F.

doi:10.1186/s40635-017-0138-1

Intensive Care Medicine Experimental

Table 2 Lung function data in animals with lung over-distension (OD) combined with either high (H_DS) or low (H_DS) dynamic strain

From: The role of high airway pressure and dynamic strain on ventilator-induced lung injury in a heterogeneous acute lung injury model

		BL	T0	T1	T2	T3	T4	T5	T6
Pplat (cmH₂O)	OD H_DS	18.2 ± 1.47	40 ± 0.0	40 ± 0.0	40 ± 0.0	40 ± 0.0	40 ± 0.0	40 ± 0.0	40 ± 0.0
Pplat (cmH₂O)	OD L_DS	19.5 ± 1.64	40 ± 0.0	40 ± 0.0	40 ± 0.0	40 ± 0.0	40 ± 0.0	40 ± 0.0	40 ± 0.0
Pmean (cmH₂O)	OD H_DS	9.9 ± 1.0	29.7 ± 3.7^‡	30.2 ± 2.6^‡	31.0 ± 1.9^‡	32.0 ± 3.0^‡	32.7 ± 2.7^‡	32.7 ± 2.3	32.7 ± 2.3^‡
Pmean (cmH₂O)	OD L_DS	11.0 ± 1.5	36.3 ± 0.5^‡	36.0 ± 1.1^‡	36.2 ± 1.3^‡	36.0 ± 0.6^‡	35.8 ± 1.0^‡	35.8 ± 1.0^‡	35.8 ± 1.0^‡
EEP (cmH₂O)	OD H_DS	5 ± 0.0	2.5 ± 1.2^‡	2.7 ± 1.1^‡	2.7 ± 1.0^‡	3.2 ± 1.6^‡	3.3 ± 1.3^‡	3.1 ± 1.0^‡	3.0 ± 1.2^‡
EEP (cmH₂O)	OD L_DS	5 ± 0.0	11.7 ± 2.8^‡	12.2 ± 3.2^‡	12.3 ± 4.0^‡	12.7 ± 3.2^‡	13.2 ± 3.1^‡	12.7 ± 3.6^‡	12.9 ± 2.7^‡
Driving pressure (cmH₂O)	OD H_DS	14.4 ± 2.3	39.7 ± 6.2^‡	37.3 ± 1.2^‡	36.5 ± 1.9^‡	36.3 ± 3.0^‡	35.8 ± 2.7^‡	36.1 ± 2.5^‡	35.6 ± 2.4^‡
Driving pressure (cmH₂O)	OD L_DS	15.4 ± 2.8	28.3 ± 2.6^‡	27.7 ± 2.6^‡	27.6 ± 4.0^‡	26.3 ± 2.1^‡	26.4 ± 2.5^‡	25.6 ± 2.9^‡	26.8 ± 3.1^‡
Vt (mL/breath)	OD H_DS	424 ± 100	1067 ± 441	1112 ± 453	1038 ± 552	954 ± 580	920 ± 546	885 ± 500	878 ± 499
Vt (mL/breath)	OD L_DS	460 ± 65	522 ± 153	658 ± 198	718 ± 230	722 ± 250	727 ± 260	726 ± 265	725 ± 156
Vt/kg (mL/kg/breath)	OD H_DS ^†	10.0 ± 0.0	25.3 ± 3.9^‡	26.8 ± 5.1^‡	24.8 ± 9.9^‡	22.8 ± 10.1^‡	22.0 ± 9.3^‡	21.1 ± 8.4^‡	21.0 ± 8.5^‡
Vt/kg (mL/kg/breath)	OD L_DS ^†	10.1 ± 0.1	11.5 ± 3.4^‡	14.3 ± 3.1^‡	15.6 ± 3.8^‡	15.7 ± 4.4^‡	15.7 ± 4.4^‡	15.7 ± 4.4^‡	15.7 ± 4.2^‡
T_Low(s)	OD H_D ^†	N/A	1.6 ± 0.3^‡	1.7 ± 0.4^‡	1.5 ± 0.6^‡	1.4 ± 0.6^‡	1.3 ± 0.6^‡	1.3 ± 0.6^‡	1.3 ± 0.6^‡
T_Low(s)	OD L_DS ^†	N/A	0.5 ± 0.1^‡	0.63 ± 0.2^‡	0.64 ± 0.1^‡	0.62 ± 0.1 ^‡	0.62 ± 0.2^‡	0.63 ± 0.2^‡	0.63 ± 0.2^‡
Resistance(cmH₂O/L/s)	OD H_DS	11.3 ± 3.0	19.1 ± 5.0	19.5 ± 5.0	21.5 ± 7.7	21.5 ± 6.9	21.4 ± 7.1	21.7 ± 6.2	21.9 ± 6.6
Resistance(cmH₂O/L/s)	OD L_DS	12.4 ± 3.9	18.0 ± 5.5	17.8 ± 5.8	17.3 ± 5.8	17.4 ± 6.1	17.8 ± 6.5	17.9 ± 6.5	17.7 ± 6.4
Compliance (mL/cmH₂O)	OD H_DS	30.0 ± 7.2	26.3 ± 6.4	30.0 ± 12.2	28.8 ± 15.7	28.2 ± 18.1	27.8 ± 17.5	26.2 ± 15.6	24.5 ± 14.2
Compliance (mL/cmH₂O)	OD L_DS	30.6 ± 6.7	18.7 ± 6.3	24.3 ± 8.6	27.1 ± 10.6	24.6 ± 10.5	27.9 ± 10.3	29.2 ± 12.1	27.8 ± 11.0
Ptp (cmH₂O/respiratory cycle)	OD H_DS	12.5 ± 1.8	34.2 ± 2.5	34.2 ± 2.1	33.7 ± 2.9	32.3 ± 5.0	33.0 ± 3.3	32.7 ± 3.3	33.6 ± 3.7
Ptp (cmH₂O/respiratory cycle)	OD L_DS	15.1 ± 5.0	30.9 ± 7.8	30.7 ± 7.6	30.7 ± 7.6	31.0 ± 7.8	30.8 ± 7.6	30.3 ± 7.9	30.2 ± 7.8
El (cmH₂O/L)	OD H_DS	21.6 ± 2.9	33.6 ± 10.7	33.0 ± 12.1	42.3 ± 33.1	40.3 ± 25.4	41.5 ± 22.4	41.9 ± 22.4	44.4 ± 24.9
El (cmH₂O/L)	OD L_DS	22.6 ± 8.5	49.8 ± 17.5	45.2 ± 20.2	43.6 ± 21.5	43.3 ± 22.0	40.9 ± 23.7	36.3 ± 27.6	39.3 ± 21.8
Ecw (cmH₂O/L)	OD H_DS	10.3 ± 4.5	6.6 ± 4.5	5.1 ± 3.2	7.3 ± 4.5	9.8 ± 7.7	9.5 ± 7.0	9.6 ± 6.6	8.5 ± 7.0
Ecw (cmH₂O/L)	OD L_DS	10.6 ± 5.7	8.3 ± 5.7	7.6 ± 3.4	7.2 ± 3.6	7.0 ± 4.1	7.0 ± 4.9	7.7 ± 5.4	7.2 ± 4.5
pH	OD H_DS	7.49 ± 0.1	7.54 ± 0.1	7.50 ± 0.1	7.48 ± 0.1	7.44 ± 0.1	7.42 ± 0.1	7.39 ± 0.1	7.38 ± 0.1
pH	OD L_DS	7.44 ± 0.1	7.37 ± 0.1	7.41 ± 0.1	7.40 ± 0.1	7.38 ± 0.1	7.37 ± 0.1	7.36 ± 0.1	7.35 ± 0.1
PaO₂ (mmHg)	OD H_DS	528.5 ± 99	100.2 ± 77	96.1 ± 61	77.2 ± 52	86.9 ± 71	94.7 ± 65	70.1 ± 28	67.5 ± 24
PaO₂ (mmHg)	OD L_DS	497.8 ± 93	146.2 ± 136	242.7 ± 154	113.2 ± 52	83.5 ± 22	87.3 ± 14	86.3 ± 19	90.6 ± 17
PaCO₂ (mmHg)	OD H_DS	37.5 ± 3.7	33.1 ± 6.3	25.7 ± 7.4	28.9 ± 17.3	30.6 ± 18.8	32.7 ± 19.2	33.8 ± 18.7	34.0 ± 20.9
PaCO₂ (mmHg)	OD L_DS	39.3 ± 5.6	41.9 ± 12.2	31.7 ± 10.7	29.2 ± 15.3	29.2 ± 14.0	28.5 ± 12.4	27.8 ± 14.9	28.9 ± 15.3
FiO₂ (%)	OD H_DS ^†	1.00 ± 0.0	1.00 ± 0.0	0.83 ± 0.20	0.72 ± 0.30	0.72 ± 0.30	0.70 ± 0.30	0.64 ± 0.30	0.64 ± 0.30
FiO₂ (%)	OD L_DS ^†	1.00 ± 0.0	1.00 ± 0.0	0.67 ± 0.20	0.37 ± 0.10	0.38 ± 0.30	0.43 ± 0.30	0.42 ± 0.30	0.37 ± 0.30
P/F (mmHg)	OD H_DS ^†	528.5 ± 99	100.3 ± 77	143.6 ± 142^‡	141.7 ± 115^‡	155.6 ± 133^‡	169.9 ± 126^‡	166.5 ± 123^‡	162.0 ± 124^‡
P/F (mmHg)	OD L_DS ^†	459.2 ± 124	146.2 ± 136	367.2 ± 155^‡	342.6 ± 167	322.5 ± 189	298.7 ± 158^‡	311.4 ± 160^‡	332.9 ± 156^‡

^†Significant difference within group over time, ^‡significant difference between groups, N/A = Not applicable
Parameters are plateau airway pressure (Pplat, cmH₂O), mean airway pressure (Pmean, cmH₂O), end-expiratory pressure (EEP, cmH₂O), driving pressure = tidal volume/compliance, tidal volume (Vt), the expiratory time during expiration (T_Low, s), airway resistance (resistance, cmH₂O/L/s), lung compliance (compliance, mL/cmH₂O), transpulmonary pressure (Ptp, cmH₂O/respiratory cycle), lung elastance (El, cmH₂O/L), chest wall compliance (Ecw, cmH₂O/L), arterial blood pH, PaO₂, PaCO₂, fraction of inspired oxygen (FiO₂, %), and PaO₂/FiO₂ ratio (P/F). Data mean ± SEM

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