Induction of subject-ventilator asynchrony by variation of respiratory parameters in a lung injury model in pigs

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

Abstract

Background: Subject-ventilator asynchrony (SVA) was shown to be associated with negative clinical outcomes. To elucidate pathophysiology pathways and effects of SVA on lung tissue histology a reproducible animal model of artificially induced asynchrony was developed and evaluated. Methods: Alterations in ventilator parameters were used to induce the three main types of asynchrony: ineffective efforts (IE), auto-triggering (AT), and double-triggering (DT). Airway flow and pressure, as well as oesophageal pressure waveforms, were recorded, asynchrony cycles were manually classified and the asynchrony index (AIX) was calculated. Bench tests were conducted on an active lung simulator with ventilator settings altered cycle by cycle. The developed algorithm was evaluated in three pilot experiments and a study in pigs ventilated for twelve hours with AIX = 25%. Results: IE and AT were induced reliably and fail-safe by end-expiratory hold and adjustment of respiratory rate, respectively. DT was provoked using airway pressure ramp prolongation, however not controlled specifically in the pilots. In the subsequent study, an AIX = 28.8% [24.0%-34.4%] was induced and maintained over twelve hours. Conclusions: The method allows to reproducibly induce and maintain three clinically relevant types of SVA observed in ventilated patients and may thus serve as a useful tool for future investigations on cellular and inflammatory effects of asynchrony.

Details

OriginalspracheEnglisch
Aufsatznummer358
FachzeitschriftRespiratory research
Jahrgang25
Ausgabenummer1
PublikationsstatusVeröffentlicht - Dez. 2024
Peer-Review-StatusJa

Externe IDs

PubMed 39363180
ORCID /0000-0003-2185-1819/work/173988639
ORCID /0000-0002-5385-9607/work/173988760
ORCID /0000-0003-4397-1467/work/173989044

Schlagworte

ASJC Scopus Sachgebiete

Schlagwörter

  • Auto-triggering, Double-triggering, Ineffective efforts, Large animal model, Subject-ventilator asynchrony