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1 Biomedical Engineering, Boston University, Boston, Massachusetts, United States
2 Biomedical Engineering, Boston University, Boston, Massachusetts, United States; CelluTraf Sci, Boston, Massachusetts, United States
3 Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States
* To whom correspondence should be addressed. E-mail: bsuki{at}bu.edu.
Variable ventilation (VV), in which tidal volume (VT) and breathing rate (f) are varied from breath to breath, has been shown to improve lung mechanics and blood oxygenation during acute lung injury in many species compared to conventional ventilation (CV), in which VT and f are constant. Since during ventilation of mice with CV as well as VV, the lungs tend to collapse over time, the goal of this study was to develop a new VV mode (VVN) with an optimized distribution of VT to maximize recruitment. Groups of normal and HCl injured mice were ventilated for 1 hr with CV, original VV (VVO), CV with periodic large breaths (CVLB) and VVN. The effects of ventilation modes on respiratory mechanics, airway pressure, blood oxygenation and interleukin (IL)-1
were assessed. During CV and VVO, both normal and injured mice showed regional lung collapse with increased airway pressures and poor oxygenation. Ventilation with CVLB and VVN resulted in a stable dynamic equilibrium with significantly improved respiratory mechanics and oxygenation. Nevertheless, VVN provided a consistently better physiological response. In injured mice, both VVO and VVN, but not CVLB, were able to minimize the IL-1
related inflammatory response compared to CV. In conclusion, our results suggest that the application of larger VT's than the single VT currently used in clinical situations helps stabilize lung function. Additionally, variable stretch patterns delivered to the lung by VV can reduce the progression of lung injury due to ventilation in injured mice.
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