Imaging atelectrauma in Ventilator-Induced Lung Injury using 4D X-ray microscopy

Abstract Mechanical ventilation can damage the lungs, a condition called Ventilator-Induced Lung Injury (VILI). However, the mechanisms leading to VILI at the microscopic scale remain poorly understood. Here we investigated the within-tidal dynamics of cyclic recruitment/derecruitment (R/D) using sy...

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Autores principales:	Luca Fardin, Ludovic Broche, Goran Lovric, Alberto Mittone, Olivier Stephanov, Anders Larsson, Alberto Bravin, Sam Bayat
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/39895291318d4f7c81ec978c54a82cea
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spelling	oai:doaj.org-article:39895291318d4f7c81ec978c54a82cea2021-12-02T14:04:00ZImaging atelectrauma in Ventilator-Induced Lung Injury using 4D X-ray microscopy10.1038/s41598-020-77300-x2045-2322https://doaj.org/article/39895291318d4f7c81ec978c54a82cea2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-77300-xhttps://doaj.org/toc/2045-2322Abstract Mechanical ventilation can damage the lungs, a condition called Ventilator-Induced Lung Injury (VILI). However, the mechanisms leading to VILI at the microscopic scale remain poorly understood. Here we investigated the within-tidal dynamics of cyclic recruitment/derecruitment (R/D) using synchrotron radiation phase-contrast imaging (PCI), and the relation between R/D and cell infiltration, in a model of Acute Respiratory Distress Syndrome in 6 anaesthetized and mechanically ventilated New-Zealand White rabbits. Dynamic PCI was performed at 22.6 µm voxel size, under protective mechanical ventilation [tidal volume: 6 ml/kg; positive end-expiratory pressure (PEEP): 5 cmH2O]. Videos and quantitative maps of within-tidal R/D showed that injury propagated outwards from non-aerated regions towards adjacent regions where cyclic R/D was present. R/D of peripheral airspaces was both pressure and time-dependent, occurring throughout the respiratory cycle with significant scatter of opening/closing pressures. There was a significant association between R/D and regional lung cellular infiltration (p = 0.04) suggesting that tidal R/D of the lung parenchyma may contribute to regional lung inflammation or capillary-alveolar barrier dysfunction and to the progression of lung injury. PEEP may not fully mitigate this phenomenon even at high levels. Ventilation strategies utilizing the time-dependence of R/D may be helpful in reducing R/D and associated injury.Luca FardinLudovic BrocheGoran LovricAlberto MittoneOlivier StephanovAnders LarssonAlberto BravinSam BayatNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Luca Fardin Ludovic Broche Goran Lovric Alberto Mittone Olivier Stephanov Anders Larsson Alberto Bravin Sam Bayat Imaging atelectrauma in Ventilator-Induced Lung Injury using 4D X-ray microscopy
description	Abstract Mechanical ventilation can damage the lungs, a condition called Ventilator-Induced Lung Injury (VILI). However, the mechanisms leading to VILI at the microscopic scale remain poorly understood. Here we investigated the within-tidal dynamics of cyclic recruitment/derecruitment (R/D) using synchrotron radiation phase-contrast imaging (PCI), and the relation between R/D and cell infiltration, in a model of Acute Respiratory Distress Syndrome in 6 anaesthetized and mechanically ventilated New-Zealand White rabbits. Dynamic PCI was performed at 22.6 µm voxel size, under protective mechanical ventilation [tidal volume: 6 ml/kg; positive end-expiratory pressure (PEEP): 5 cmH2O]. Videos and quantitative maps of within-tidal R/D showed that injury propagated outwards from non-aerated regions towards adjacent regions where cyclic R/D was present. R/D of peripheral airspaces was both pressure and time-dependent, occurring throughout the respiratory cycle with significant scatter of opening/closing pressures. There was a significant association between R/D and regional lung cellular infiltration (p = 0.04) suggesting that tidal R/D of the lung parenchyma may contribute to regional lung inflammation or capillary-alveolar barrier dysfunction and to the progression of lung injury. PEEP may not fully mitigate this phenomenon even at high levels. Ventilation strategies utilizing the time-dependence of R/D may be helpful in reducing R/D and associated injury.
format	article
author	Luca Fardin Ludovic Broche Goran Lovric Alberto Mittone Olivier Stephanov Anders Larsson Alberto Bravin Sam Bayat
author_facet	Luca Fardin Ludovic Broche Goran Lovric Alberto Mittone Olivier Stephanov Anders Larsson Alberto Bravin Sam Bayat
author_sort	Luca Fardin
title	Imaging atelectrauma in Ventilator-Induced Lung Injury using 4D X-ray microscopy
title_short	Imaging atelectrauma in Ventilator-Induced Lung Injury using 4D X-ray microscopy
title_full	Imaging atelectrauma in Ventilator-Induced Lung Injury using 4D X-ray microscopy
title_fullStr	Imaging atelectrauma in Ventilator-Induced Lung Injury using 4D X-ray microscopy
title_full_unstemmed	Imaging atelectrauma in Ventilator-Induced Lung Injury using 4D X-ray microscopy
title_sort	imaging atelectrauma in ventilator-induced lung injury using 4d x-ray microscopy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/39895291318d4f7c81ec978c54a82cea
work_keys_str_mv	AT lucafardin imagingatelectraumainventilatorinducedlunginjuryusing4dxraymicroscopy AT ludovicbroche imagingatelectraumainventilatorinducedlunginjuryusing4dxraymicroscopy AT goranlovric imagingatelectraumainventilatorinducedlunginjuryusing4dxraymicroscopy AT albertomittone imagingatelectraumainventilatorinducedlunginjuryusing4dxraymicroscopy AT olivierstephanov imagingatelectraumainventilatorinducedlunginjuryusing4dxraymicroscopy AT anderslarsson imagingatelectraumainventilatorinducedlunginjuryusing4dxraymicroscopy AT albertobravin imagingatelectraumainventilatorinducedlunginjuryusing4dxraymicroscopy AT sambayat imagingatelectraumainventilatorinducedlunginjuryusing4dxraymicroscopy
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Imaging atelectrauma in Ventilator-Induced Lung Injury using 4D X-ray microscopy

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