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Design of a new variable-ventilation method optimized for lung recruitment in mice

¹Department of Biomedical Engineering, Boston University; and ²CelluTraf Sci., Boston, Massachusetts

Submitted 20 September 2007 ; accepted in final form 11 March 2008

Variable ventilation (VV), characterized by breath-to-breath variation of tidal volume (VT) and breathing rate (f), has been shown to improve lung mechanics and blood oxygenation during acute lung injury in many species compared with conventional ventilation (CV), characterized by constant VT and f. During CV as well as VV, the lungs of mice tend to collapse over time; therefore, the goal of this study was to develop a new VV mode (VV_N) with an optimized distribution of VT to maximize recruitment. Groups of normal and HCl-injured mice were subjected to 1 h of CV, original VV (VV_O), CV with periodic large breaths (CV_LB), and VV_N, and the effects of ventilation modes on respiratory mechanics, airway pressure, blood oxygenation, and IL-1β were assessed. During CV and VV_O, normal and injured mice showed regional lung collapse with increased airway pressures and poor oxygenation. CV_LB and VV_N resulted in a stable dynamic equilibrium with significantly improved respiratory mechanics and oxygenation. Nevertheless, VV_N provided a consistently better physiological response. In injured mice, VV_O and VV_N, but not CV_LB, were able to reduce the IL-1β-related inflammatory response compared with CV. In conclusion, our results suggest that application of higher VT values than the single VT currently used in clinical situations helps stabilize lung function. In addition, variable stretch patterns delivered to the lung by VV can reduce the progression of lung injury due to ventilation in injured mice.

acute respiratory distress syndrome; lung injury; elastance; gas exchange

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