Equal increases in respiratory system elastance reflect similar lung damage in experimental ventilator-induced lung injury

Silvio Sibilla, Stefano Tredici, Giuliana Porro, Manuela Irace, Massimiliano Guglielmi, Gabriella Nicolini, Giovanni Tredici, Franco Valenza, Luciano Gattinoni

Research output: Contribution to journalArticle

Abstract

Objective: We hypothesized that a 50% increase in respiratory system elastance (Ers) would indicate similar degree of lung damage (equi-damage, ED), independently of ventilation strategy. Design and setting: A prospective, randomized animal laboratory investigation at a university hospital laboratory. Subjects: 35 anesthetized, paralyzed, mechanically ventilated male Sprague-Dawley rats. Interventions: Each rat was ventilated with a different combination of tidal volume, positive end-expiratory pressure, and inspired fraction of oxygen. Ers was determined throughout the experiment; the studies were interrupted when Ers reached 150% (ED) of its baseline value, or after 5 h. Measurements and results. Lung wet to dry weight ratio (W/D) was assessed. Morphological damage of the lung was scored on a grading of perivascular edema, hemorrhage, and breaks in the alveolar septa to obtain a total injury score. Twenty-four rats achieved an Ers of 150%: nine within 1 h (class 1), nine in 1-2 h (class 2), and six in 2-5 h (class 3). Eleven rats did not reach the target 50% increase in Ers (class 4). W/D was higher in rats that reached the target than in those that did not. W/D did not differ among rats that reached ED. Similarly, the total injury score did not differ among classes 1-3 but was higher than class 4. Conclusions: In the setting of VILI a 50% increase in Ers corresponds to an equal level of lung damage, irrespective of ventilatory setting and time of ventilation.

Original languageEnglish
Pages (from-to)196-203
Number of pages8
JournalIntensive Care Medicine
Volume28
Issue number2
DOIs
Publication statusPublished - 2002

Keywords

  • Respiratory system elastance
  • Ventilator-induced lung injury

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Sibilla, S., Tredici, S., Porro, G., Irace, M., Guglielmi, M., Nicolini, G., Tredici, G., Valenza, F., & Gattinoni, L. (2002). Equal increases in respiratory system elastance reflect similar lung damage in experimental ventilator-induced lung injury. Intensive Care Medicine, 28(2), 196-203. https://doi.org/10.1007/s00134-001-1177-2