ArticleCritical care (London, England)2011
Positive end-expiratory pressure optimization with forced oscillation technique reduces ventilator induced lung injury: a controlled experimental study in pigs with saline lavage lung injury.
Article in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01506284 (Assessment of Airways Mechanical Properties by Forced Oscillatory Technique), which is not on this map. Cited by 10 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Assessment of Airways Mechanical Properties by Forced Oscillatory Technique (FOT) and Laser Interferometry (LIR) During Anesthesia.
Who cites it
10 citing papers in PubMed, 23 citations in OpenAlex.
- Review
- Clinical significance and applications of oscillometry.European respiratory review : an official journal of the European Respiratory Society · 2022Review
- Oscillatory mechanics at birth for identifying infants requiring surfactant: a prospective, observational trial.Respiratory research · 2021Observational
- Role of Lung Function Monitoring by the Forced Oscillation Technique for Tailoring Ventilation and Weaning in Neonatal ECMO: New Insights From a Case Report.Frontiers in pediatrics · 2018Article
- Trends in mechanical ventilation: are we ventilating our patients in the best possible way?Breathe (Sheffield, England) · 2017Review
- Intratidal Overdistention and Derecruitment in the Injured Lung: A Simulation Study.IEEE transactions on bio-medical engineering · 2017Article
- The differential effects of inspiratory, expiratory, and combined resistive breathing on healthy lung.International journal of chronic obstructive pulmonary disease · 2016Article
- Relationship between respiratory impedance and positive end-expiratory pressure in mechanically ventilated neonates.Intensive care medicine · 2013Article
- Article
- Optimizing positive end-expiratory pressure by oscillatory mechanics minimizes tidal recruitment and distension: an experimental study in a lavage model of lung injury.Critical care (London, England) · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionProtocols using high levels of positive end-expiratory pressure (PEEP) in combination with low tidal volumes have been shown to reduce mortality in patients with severe acute respiratory distress syndrome (ARDS). However, the optimal method for setting PEEP is yet to be defined. It has been shown that respiratory system reactance (Xrs), measured by the forced oscillation technique (FOT) at 5 Hz, may be used to identify the minimal PEEP level required to maintain lung recruitment. The aim of the present study was to evaluate if using Xrs for setting PEEP would improve lung mechanics and reduce lung injury compared to an oxygenation-based approach.
methods17 pigs, in which acute lung injury (ALI) was induced by saline lavage, were studied. Animals were randomized into two groups: in the first PEEP was titrated according to Xrs (FOT group), in the control group PEEP was set according to the ARDSNet protocol (ARDSNet group). The duration of the trial was 12 hours. In both groups recruitment maneuvers (RM) were performed every 2 hours, increasing PEEP to 20 cmH2O. In the FOT group PEEP was titrated by monitoring Xrs while PEEP was reduced from 20 cmH2O in steps of 2 cmH2O. PEEP was considered optimal at the step before which Xrs started to decrease. Ventilatory parameters, lung mechanics, blood gases and hemodynamic parameters were recorded hourly. Lung injury was evaluated by histopathological analysis.
resultsThe PEEP levels set in the FOT group were significantly higher compared to those set in the ARDSNet group during the whole trial. These higher values of PEEP resulted in improved lung mechanics, reduced driving pressure, improved oxygenation, with a trend for higher PaCO2 and lower systemic and pulmonary pressure. After 12 hours of ventilation, histopathological analysis showed a significantly lower score of lung injury in the FOT group compared to the ARDSNet group.
conclusionsIn a lavage model of lung injury a PEEP optimization strategy based on maximizing Xrs attenuated the signs of ventilator induced lung injury. The respiratory system reactance measured by FOT could thus be an important component in a strategy for delivering protective ventilation to patients with ARDS/acute lung injury.
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