Physiological effects of an open lung ventilatory strategy titrated on elastance-derived end-inspiratory transpulmonary pressure: Study in a pig model

Critical Care Medicine

Volumn 40, Issue 7, 2012, Pages 2124-2131

  Staffieri, Francesco ^a   Stripoli, Tania ^b   De Monte, Valentina ^a   Crovace, Antonio ^a   Sacchi, Marianna ^c   De Michele, Michele ^c   Trerotoli, Paolo ^d   Terragni, Pierpaolo ^e   Ranieri, V Marco ^e   Grasso, Salvatore ^c  

^a Dipartimento dell'Emergenza e Trapianti d'Organo   (Italy)

^b Sezione di Anestesiologia e Rianimazione   (Italy)

^c Sezione di Anestesiologia e Rianimazione   (Italy)

^d UNIVERSITY OF BARI   (Italy)

^e UNIVERSITY OF TURIN   (Italy)

Author keywords

ARDS; open lung ventilatory approach; transpulmonary pressure

Indexed keywords

CARBON DIOXIDE; HYDROCHLORIC ACID;

ABDOMEN; ABDOMINAL PRESSURE; ADULT RESPIRATORY DISTRESS SYNDROME; ANIMAL EXPERIMENT; ANIMAL MODEL; ARTICLE; ARTIFICIAL VENTILATION; ASSISTED VENTILATION; BLOOD CARBON DIOXIDE TENSION; BLOOD VOLUME; BREATHING RATE; CHEST WALL ELASTANCE; COMPLIANCE (PHYSICAL); COMPUTER ASSISTED TOMOGRAPHY; END INSPIRATORY TRANSPULMONARY PRESSURE; EXPERIMENTAL PIG; HEART OUTPUT; HEART RATE; HEART RIGHT ATRIUM PRESSURE; HEART STROKE VOLUME; INTERMETHOD COMPARISON; LUNG COMPLIANCE; LUNG FLUID; LUNG PRESSURE; LUNG WEIGHT; MEAN ARTERIAL PRESSURE; NONHUMAN; OPEN LUNG VENTILATION; PH; POSITIVE END EXPIRATORY PRESSURE; PRIORITY JOURNAL; RESPIRATORY SYSTEM ELASTANCE; THERAPY EFFECT; THORAX WALL; TIDAL VOLUME; VASCULAR RESISTANCE;

ACUTE LUNG INJURY; ANIMALS; BLOOD VOLUME; CARBON DIOXIDE; CARDIAC OUTPUT; CONTINUOUS POSITIVE AIRWAY PRESSURE; DISEASE MODELS, ANIMAL; LUNG VOLUME MEASUREMENTS; OXYGEN; POSITIVE-PRESSURE RESPIRATION; RADIOGRAPHY, THORACIC; STROKE VOLUME; SWINE; TOMOGRAPHY, X-RAY COMPUTED;

EID: 84862738465     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0b013e31824e1b65     Document Type: Article

References (56)

1. Malbrain ML, Cheatham ML, Kirkpatrick A, et al: Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions. Intensive Care Med 2006; 32:1722-1732 (Pubitemid 44607359)
2. Hess DR, Bigatello LM: The chest wall in acute lung injury/acute respiratory distress syndrome. Curr Opin Crit Care 2008; 14:94-102
3. Grasso S, Mascia L, Del Turco M, et al: Effects of recruiting maneuvers in patients with acute respiratory distress syndrome ventilated with protective ventilatory strategy. Anesthesiology 2002; 96:795-802 (Pubitemid 34266671)
4. Ranieri VM, Brienza N, Santostasi S, et al: Impairment of lung and chest wall mechanics in patients with acute respiratory distress syndrome: Role of abdominal distension. Am J Respir Crit Care Med 1997; 156(4 Pt 1):1082-1091
5. Talmor D, Sarge T, Malhotra A, et al: Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med 2008; 359:2095-2104
6. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The acute respiratory distress syndrome network. The Acute Respiratory Distress Syndrome Network. N Engl J Med 2000; 342:1301-1308
7. Mercat A, Richard JC, Vielle B, et al; Expiratory Pressure (Express) Study Group: Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: A randomized controlled trial. JAMA 2008; 299:646-655 (Pubitemid 351252726)
8. Brower RG, Lanken PN, MacIntyre N, et al; National Heart, Lung, and Blood Institute ARDS Clinical Trials Network: Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med 2004; 351:327-336
9. Meade MO, Cook DJ, Guyatt GH, et al; Lung Open Ventilation Study Investigators: Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: A randomized controlled trial. JAMA 2008; 299:637-645 (Pubitemid 351252725)
10. Briel M, Meade M, Mercat A, et al: Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: Systematic review and meta-analysis. JAMA 2010; 303:865-873
11. Esan A, Hess DR, Raoof S, et al: Severe hypoxemic respiratory failure: Part 1-ventilatory strategies. Chest 2010; 137: 1203-1216
12. Chiumello D, Carlesso E, Cadringher P, et al: Lung stress and strain during mechanical ventilation for acute respiratory distress syndrome. Am J Respir Crit Care Med 2008; 178:346-355
13. Gattinoni L, Chiumello D, Carlesso E, et al: Bench-to-bedside review: Chest wall elastance in acute lung injury/acute respiratory distress syndrome patients. Crit Care 2004; 8:350-355 (Pubitemid 39468056)
14. Meybohm P, Gruenewald M, Höcker J, et al: Correlation and agreement between the bispectral index vs. state entropy during hypothermic cardio-pulmonary bypass. Acta Anaesthesiol Scand 2010; 54:169-175
15. Morgan P, Al-Subaie N, Rhodes A: Minimally invasive cardiac output monitoring. Curr Opin Crit Care 2008; 14:322-326 (Pubitemid 351667918)
16. ilic-Emili J, Mead J, Turner JM: Topography of esophageal pressure as a function of posture in man. J Appl Physiol 1964; 19:212-216
17. ilic-Emili J, Mead J, Turner JM, et al: Improved technique for estimating pleural pressure from esophageal balloons. J Appl Physiol 1964; 19:207-211
18. Turnbull D, Webber S, Hamnegard CH, et al: Intra-abdominal pressure measurement: Validation of intragastric pressure as a measure of intra-abdominal pressure. Br J Anaesth 2007; 98:628-634 (Pubitemid 47072617)
19. Chiumello D, Gallazzi E, Marino A, et al: A validation study of a new nasogastric polyfunctional catheter. Intensive Care Med 2011; 37:791-795
20. Talmor D, Sarge T, O'Donnell CR, et al: Esophageal and transpulmonary pressures in acute respiratory failure. Crit Care Med 2006; 34:1389-1394
21. Baydur A, Behrakis PK, Zin WA, et al: A simple method for assessing the validity of the esophageal balloon technique. Am Rev Respir Dis 1982; 126:788-791 (Pubitemid 13241057)
22. Grasso S, Fanelli V, Cafarelli A, et al: Effects of high versus low positive end-expiratory pressures in acute respiratory distress syndrome. Am J Respir Crit Care Med 2005; 171:1002-1008 (Pubitemid 40616949)
23. Gattinoni L, Vagginelli F, Chiumello D, et al: Physiologic rationale for ventilator setting in acute lung injury/acute respiratory distress syndrome patients. Crit Care Med 2003; 31(Suppl 4):S300-S304 (Pubitemid 36458183)
24. Ranieri VM, Giuliani R, Fiore T, et al: Volume-pressure curve of the respiratory system predicts effects of PEEP in ARDS: "occlusion" versus "constant flow" technique. Am J Respir Crit Care Med 1994; 149:19-27
25. Ranieri VM, Zhang H, Mascia L, et al: Pressure-time curve predicts minimally injurious ventilatory strategy in an isolated rat lung model. Anesthesiology 2000; 93:1320-1328
26. Grasso S, Stripoli T, De Michele M, et al: ARDSnet ventilatory protocol and alveolar hyperinflation: Role of positive end-expiratory pressure. Am J Respir Crit Care Med 2007; 176:761-767 (Pubitemid 47598477)
27. Grasso S, Terragni P, Mascia L, et al: Airway pressure-time curve profile (stress index) detects tidal recruitment/hyperinflation in experimental acute lung injury. Crit Care Med 2004; 32:1018-1027 (Pubitemid 38471525)
28. Puybasset L, Cluzel P, Gusman P, et al: Regional distribution of gas and tissue in acute respiratory distress syndrome. I. Consequences for lung morphology. CT Scan ARDS Study Group. Intensive Care Med 2000; 26:857-869 (Pubitemid 30616038)
29. Puybasset L, Gusman P, Muller JC, et al: Regional distribution of gas and tissue in acute respiratory distress syndrome. III. Consequences for the effects of positive end-expiratory pressure. CT Scan ARDS Study Group. Adult Respiratory Distress Syndrome. Intensive Care Med 2000; 26:1215-1227
30. Rouby JJ, Puybasset L, Cluzel P, et al: Regional distribution of gas and tissue in acute respiratory distress syndrome. II. Physiological correlations and definition of an ARDS Severity Score. CT Scan ARDS Study Group. Intensive Care Med 2000; 26:1046-1056
31. Caironi P, Cressoni M, Chiumello D, et al: Lung opening and closing during ventilation of acute respiratory distress syndrome. Am J Respir Crit Care Med 2010; 181:578-586
32. Rosenthal C, Caronia C, Quinn C, et al: A comparison among animal models of acute lung injury. Crit Care Med 1998; 26:912-916 (Pubitemid 28211403)
33. Grasso S, Puntillo F, Mascia L, et al: Compensation for increase in respiratory workload during mechanical ventilation. Pressure-support versus proportional-assist ventilation. Am J Respir Crit Care Med 2000; 161(3 Pt 1):819-826 (Pubitemid 30171737)
34. Hussain SN, Rabinovitch B, Macklem PT, et al: Effects of separate rib cage and abdominal restriction on exercise performance in normal humans. J Appl Physiol 1985; 58:2020-2026 (Pubitemid 15014876)
35. Hussain SN, Pardy RL: Inspiratory muscle function with restrictive chest wall loading during exercise in normal humans. J Appl Physiol 1985; 58:2027-2032 (Pubitemid 15014877)
36. Regli A, Hockings LE, Musk GC, et al: Commonly applied positive end-expiratory pressures do not prevent functional residual capacity decline in the setting of intra-abdominal hypertension: A pig model. Crit Care 2010; 14:R128
37. Quintel M, Pelosi P, Caironi P, et al: An increase of abdominal pressure increases pulmonary edema in oleic acid-induced lung injury. Am J Respir Crit Care Med 2004; 169:534-541 (Pubitemid 38187128)
38. Kubiak BD, Gatto LA, Jimenez EJ, et al: Plateau and transpulmonary pressure with elevated intra-abdominal pressure or atelectasis. J Surg Res 2010; 159:e17-e24
39. Loring SH, O'Donnell CR, Behazin N, et al: Esophageal pressures in acute lung injury: Do they represent artifact or useful information about transpulmonary pressure, chest wall mechanics, and lung stress? J Appl Physiol 2010; 108:515-522
40. Loring SH, Pecchiari M, Della Valle P, et al: Maintaining end-expiratory transpulmonary pressure prevents worsening of ventilator-induced lung injury caused by chest wall constriction in surfactant-depleted rats. Crit Care Med 2010; 38:2358-2364
41. Brander L, Ranieri VM, Slutsky AS: Esophageal and transpulmonary pressure help optimize mechanical ventilation in patients with acute lung injury. Crit Care Med 2006; 34:1556-1558
42. Hager DN, Brower RG: Customizing lung-protective mechanical ventilation strategies. Crit Care Med 2006; 34:1554-1555
43. Hubmayr RD: Is there a place for esophageal manometry in the care of patients with injured lungs? J Appl Physiol 2010; 108: 481-482
44. Grasso S, Terragni P, Birocco A, et al: ECMO criteria for influenza A (H1N1)-associated ARDS: role of transpulmonary pressure. Intensive Care Med 2012; 38:395-403
45. Takata M, Wise RA, Robotham JL. Effects of abdominal pressure on venous return: Abdominal vascular zone conditions. J Appl Physiol 1990; 69:1961-1972
46. Luecke T, Pelosi P: Clinical review: Positive end-expiratory pressure and cardiac output. Crit Care 2005; 9:607-621. (Pubitemid 43174471)
47. Mercat A: High positive end-expiratory pressure and low tidal volume in acute respiratory distress syndrome: All right for the right ventricle? Crit Care Med 2010; 38:986-987
48. Fougeres E, Teboul JL, Richard C, et al: Hemodynamic impact of a positive end-expiratory pressure setting in acute respiratory distress syndrome: Importance of the volume status. Crit Care Med 2010; 38:802-807
49. Mekontso Dessap A, Charron C, Devaquet J, et al: Impact of acute hypercapnia and augmented positive end-expiratory pressure on right ventricle function in severe acute respiratory distress syndrome. Intensive Care Med 2009; 35:1850-1858
50. Reis Miranda D, Klompe L, Mekel J, et al: Open lung ventilation does not increase right ventricular outflow impedance: An echo-Doppler study. Crit Care Med 2006; 34:2555-2560 (Pubitemid 44413052)
51. Grasso S, Stripoli T, Sacchi M, et al: Inhomogeneity of lung parenchyma during the open lung strategy: A computed tomography scan study. Am J Respir Crit Care Med 2009; 180:415-423
52. Hernandez LA, Peevy KJ, Moise AA, et al: Chest wall restriction limits high airway pressure-induced lung injury in young rabbits. J Appl Physiol 1989; 66:2364-2368 (Pubitemid 19142393)
53. Borges JB, Okamoto VN, Matos GF, et al: Reversibility of lung collapse and hypoxemia in early acute respiratory distress syndrome. Am J Respir Crit Care Med 2006; 174:268-278 (Pubitemid 44156605)
54. Suarez-Sipmann F, Bohm SH, Tusman G, et al: Use of dynamic compliance for open lung positive end-expiratory pressure titration in an experimental study. Crit Care Med 2007; 35:214-221 (Pubitemid 46035698)
55. Terragni PP, Rosboch G, Tealdi A, et al: Tidal hyperinflation during low tidal volume ventilation in acute respiratory distress syndrome. Am J Respir Crit Care Med 2007; 175:160-166 (Pubitemid 46115087)
56. Protti A, Cressoni M, Santini A, et al: Lung stress and strain during mechanical ventilation: Any safe threshold? Am J Respir Crit Care Med 2011; 183:1354-1362