A Comparative Study of Ex-Vivo Murine Pulmonary Mechanics Under Positive- and Negative-Pressure Ventilation.
A Comparative Study of Ex-Vivo Murine Pulmonary Mechanics Under Positive- and Negative-Pressure Ventilation.
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DOI：
10.1007/s10439-023-03380-1
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发表时间：
2024-02
影响因子：
3.8
通讯作者：
Eskandari, M.
中科院分区：
文献类型：
--
作者：
Quiros, K. A. M.;Nelson, T. M.;Ulu, A.;Dominguez, E. C.;Biddle, T. A.;Lo, D. D.;Nordgren, T. M.;Eskandari, M.
关键词：
COVID-19 大流行期间呼吸机使用量的增加再次引发了有关机械通气的持续存在的问题，包括呼吸机引起的生理呼吸和人工呼吸之间的差异（即正压通气与负压通气、PPV 与 NPV）。为了解决这一争议，我们比较了在离体准静态负荷下接受 PPV 和 NPV 的小鼠标本，并通过测量不同充气频率和体积时的准静态和动态顺应性、跨肺压和能量学来量化肺力学。每个研究的机械参数都会产生通气模式之间显着变化的实例。最值得注意的是，充气顺应性、松弛百分比和峰值压力始终取决于通气模式。注意最大充气量和频率取决于通气模式。与之前有限的氧合和吸气末测量临床研究相矛盾，这里提出的以力学为中心的综合研究结果表明，肺特性取决于负荷模式，重要的是，尽管使用相同的定制设计 PPV/NPV 呼吸机，但较小和较大哺乳动物物种之间的这些依赖性有所不同。结果表明，过去有关现场通气模式比较的矛盾发现可能与所选的动物模型有关。了解 PPV 和 NPV 之间不同的基本机制可以为改进通气策略和设计以防止相关肺损伤提供见解。
Increased ventilator use during the COVID-19 pandemic resurrected persistent questions regarding mechanical ventilation including the difference between physiological and artificial breathing induced by ventilators (i.e., positive- versus negative-pressure ventilation, PPV vs NPV). To address this controversy, we compare murine specimens subjected to PPV and NPV in ex vivo quasi-static loading and quantify pulmonary mechanics via measures of quasi-static and dynamic compliances, transpulmonary pressure, and energetics when varying inflation frequency and volume. Each investigated mechanical parameter yields instance(s) of significant variability between ventilation modes. Most notably, inflation compliance, percent relaxation, and peak pressure are found to be consistently dependent on the ventilation mode. Maximum inflation volume and frequency note varied dependencies contingent on the ventilation mode. Contradictory to limited previous clinical investigations of oxygenation and end-inspiratory measures, the mechanics-focused comprehensive findings presented here indicate lung properties are dependent on loading mode, and importantly, these dependencies differ between smaller versus larger mammalian species despite identical custom-designed PPV/NPV ventilator usage. Results indicate that past contradictory findings regarding ventilation mode comparisons in the field may be linked to the chosen animal model. Understanding the differing fundamental mechanics between PPV and NPV may provide insights for improving ventilation strategies and design to prevent associated lung injuries.
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影响因子：
3.3
作者：
Eskandari, Mona;Arvayo, Alberto L.;Levenston, Marc E.
通讯作者：
Levenston, Marc E.
影响因子：
4.6
作者：
Quiros, K. A. M.;Nelson, T. M.;Sattari, S.;Mariano, C. A.;Ulu, A.;Dominguez, E. C.;Nordgren, T. M.;Eskandari, M.
通讯作者：
Eskandari, M.
影响因子：
8.8
作者：
Bruells, Christian S.;Smuder, Ashley J.;Powers, Scott K.
通讯作者：
Powers, Scott K.
影响因子：
--
作者：
Cole, Jacob H;Hughey, Scott B;Booth, Gregory J
通讯作者：
Booth, Gregory J
影响因子：
24.3
作者：
Corrado, A;Gorini, M;De Paola, E
通讯作者：
De Paola, E