Quantifying Regional Lung Deformation Using Four-Dimensional Computed Tomography: A Comparison of Conventional and Oscillatory Ventilation

Overview

Journal Front Physiol

Date 2020 Mar 11

PMID 32153417

Citations 13

Authors

Jacob Herrmann

Sarah E Gerard

Wei Shao

Monica L Hawley

Joseph M Reinhardt

Gary E Christensen

Eric A Hoffman

David W Kaczka

Affiliations

Soon will be listed here.

Abstract

Mechanical ventilation strategies that reduce the heterogeneity of regional lung stress and strain may reduce the risk of ventilator-induced lung injury (VILI). In this study, we used registration of four-dimensional computed tomographic (4DCT) images to assess regional lung aeration and deformation in 10 pigs under baseline conditions and following acute lung injury induced with oleic acid. CT images were obtained via dynamic axial imaging (Siemens SOMATOM Force) during conventional pressure-controlled mechanical ventilation (CMV), as well as high-frequency and multi-frequency oscillatory ventilation modalities (HFOV and MFOV, respectively). Our results demonstrate that oscillatory modalities reduce intratidal strain throughout the lung in comparison to conventional ventilation, as well as the spatial gradients of dynamic strain along the dorsal-ventral axis. Harmonic distortion of parenchymal deformation was observed during HFOV with a single discrete sinusoid delivered at the airway opening, suggesting inherent mechanical nonlinearity of the lung tissues. MFOV may therefore provide improved lung-protective ventilation by reducing strain magnitudes and spatial gradients of strain compared to either CMV or HFOV.

Citing Articles

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Regional ventilation dynamics of electrical impedance tomography validated with four-dimensional computed tomography: single-center, prospective, observational study.

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Time-Controlled Adaptive Ventilation (TCAV): a personalized strategy for lung protection.

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Functional imaging for assessing regional lung ventilation in preclinical and clinical research.

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