ArticleCritical care (London, England)2009
Pressure-dependent stress relaxation in acute respiratory distress syndrome and healthy lungs: an investigation based on a viscoelastic model.
Article in Critical care (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 44 citations in OpenAlex.
- Injury Mechanics in Surfactant-Depleted and Healthy Rat Lungs: A Multi-scale Consideration of Artificial and Physiological Ventilation.Annals of biomedical engineering · 2026Article
- Reply to ButlerAmerican journal of respiratory and critical care medicine · 2023Article
- Positive- and Negative-Pressure Ventilation Characterized by Local and Global Pulmonary Mechanics.American journal of respiratory and critical care medicine · 2023Article
- An enhanced respiratory mechanics model based on double-exponential and fractional calculus.Frontiers in physiology · 2023Article
- Whole-lung finite-element models for mechanical ventilation and respiratory research applications.Frontiers in physiology · 2022Article
- Non-Canonical Regulation of Type I Collagen through Promoter Binding of SOX2 and Its Contribution to Ameliorating Pulmonary Fibrosis by Butylidenephthalide.International journal of molecular sciences · 2018Article
- Driving pressure and mechanical power: new targets for VILI prevention.Annals of translational medicine · 2017Review
- Visualisation of time-varying respiratory system elastance in experimental ARDS animal models.BMC pulmonary medicine · 2014Article
- Expiratory model-based method to monitor ARDS disease state.Biomedical engineering online · 2013Article
- Iterative integral parameter identification of a respiratory mechanics model.Biomedical engineering online · 2012Article
- Respiratory system dynamical mechanical properties: modeling in time and frequency domain.Biophysical reviews · 2011Review
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLimiting the energy transfer between ventilator and lung is crucial for ventilatory strategy in acute respiratory distress syndrome (ARDS). Part of the energy is transmitted to the viscoelastic tissue components where it is stored or dissipates. In mechanically ventilated patients, viscoelasticity can be investigated by analyzing pulmonary stress relaxation. While stress relaxation processes of the lung have been intensively investigated, non-linear interrelations have not been systematically analyzed, and such analyses have been limited to small volume or pressure ranges. In this study, stress relaxation of mechanically ventilated lungs was investigated, focusing on non-linear dependence on pressure. The range of inspiratory capacity was analyzed up to a plateau pressure of 45 cmH2O.
methodsTwenty ARDS patients and eleven patients with normal lungs under mechanical ventilation were included. Rapid flow interruptions were repetitively applied using an automated super-syringe maneuver. Viscoelastic resistance, compliance and time constant were determined by multiple regression analysis using a lumped parameter model. This same viscoelastic model was used to investigate the frequency dependence of the respiratory system's impedance.
resultsThe viscoelastic time constant was independent of pressure, and it did not differ between normal and ARDS lungs. In contrast, viscoelastic resistance increased non-linearly with pressure (normal: 8.4 (7.4-11.9) [median (lower - upper quartile)] to 35.2 (25.6-39.5) cmH2O.sec/L; ARDS: 11.9 (9.2-22.1) to 73.5 (56.8-98.7)cmH2O.sec/L), and viscoelastic compliance decreased non-linearly with pressure (normal: 130.1(116.9-151.3) to 37.4(34.7-46.3) mL/cmH2O; ARDS: 125.8(80.0-211.0) to 17.1(13.8-24.7)mL/cmH2O). The pulmonary impedance increased with pressure and decreased with respiratory frequency.
conclusionsViscoelastic compliance and resistance are highly non-linear with respect to pressure and differ considerably between ARDS and normal lungs. None of these characteristics can be observed for the viscoelastic time constant. From our analysis of viscoelastic properties we cautiously conclude that the energy transfer from the respirator to the lung can be reduced by application of low inspiratory plateau pressures and high respiratory frequencies. This we consider to be potentially lung protective.
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