ArticleCritical care medicine2016
Comparative Effects of Volutrauma and Atelectrauma on Lung Inflammation in Experimental Acute Respiratory Distress Syndrome.
Article in Critical care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 1 of them a synthesis that pooled it.
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Who cites it
63 citing papers in PubMed, 1 synthesis or guideline pooled it, 116 citations in OpenAlex.
- Clinical evaluation of laryngeal mask airways in video-assisted thoracic surgery: a meta-analysis of randomized controlled trials.Journal of cardiothoracic surgery · 2024Pooled it
- Effect of intermittent recruitment manoeuvre combined with PEEP on postoperative atelectasis in obese patients: a randomized controlled trial.BMC anesthesiology · 2026Trial
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- Recruitment-to-inflation Ratio Assessed through Sequential End-expiratory Lung Volume Measurement in Acute Respiratory Distress Syndrome.Anesthesiology · 2023Trial
- Individualized positive end-expiratory pressure with and without recruitment maneuvers in obese patients during bariatric surgery.The Kaohsiung journal of medical sciences · 2022Trial
- Effect of open-lung vs conventional perioperative ventilation strategies on postoperative pulmonary complications after on-pump cardiac surgery: the PROVECS randomized clinical trial.Intensive care medicine · 2019Trial
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- Respiratory System Mechanics During Low Versus High Positive End-Expiratory Pressure in Open Abdominal Surgery: A Substudy of PROVHILO Randomized Controlled Trial.Anesthesia and analgesia · 2018Trial
- PEEP and alveolar recruitment after 60 years of acute respiratory distress syndrome.Intensive care medicine · 2026Review
- Bedside Assessment of PEEP-Induced Volume and Mechanical Power in Mechanically Ventilated Adults Without ARDS: A Post Hoc Analysis.Medical sciences (Basel, Switzerland) · 2026Article
- Low PEEP ventilation in TGF-β1 induced lung injury triggers a reversible lung mechanical deterioration without promoting persistent structural damage.Scientific reports · 2026Article
- Article
- Optimizing Positive End-Expiratory Pressure in Asymmetric Acute Lung Injury in a Porcine Model: The Role of Transpulmonary Pressure.International journal of molecular sciences · 2025Article
- Imaging and pulmonary function techniques in ARDS diagnosis and management: current insights and challenges.Critical care (London, England) · 2025Review
- Article
- Assessment of recruitment from CT to the bedside: challenges and future directions.Critical care (London, England) · 2025Review
- The potential risk of ventilator-induced lung injury from five different PEEP titration techniques in ARDS.Frontiers in medicine · 2025Article
- The PROtective VEntilation (PROVE) Network - advancing research and collaboration in mechanical ventilation.Critical care science · 2025Review
- Positive end-expiratory pressure management in patients with severe ARDS: implications of prone positioning and extracorporeal membrane oxygenation.Critical care (London, England) · 2024Review
- Exploring alveolar recruitability using positive end-expiratory pressure in mice overexpressing TGF-β1: a structure-function analysis.Scientific reports · 2024Article
3 more citing papers are in PubMed but not listed here.
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Authors and funding
17 authors at 5 institutions in 4 countries.
Funding
Abstract
objectiveVolutrauma and atelectrauma promote ventilator-induced lung injury, but their relative contribution to inflammation in ventilator-induced lung injury is not well established. The aim of this study was to determine the impact of volutrauma and atelectrauma on the distribution of lung inflammation in experimental acute respiratory distress syndrome.
designLaboratory investigation.
settingUniversity-hospital research facility. SUBJECTS: Ten pigs (five per group; 34.7-49.9 kg)
interventions: Animals were anesthetized and intubated, and saline lung lavage was performed. Lungs were separated with a double-lumen tube. Following lung recruitment and decremental positive end-expiratory pressure trial, animals were randomly assigned to 4 hours of ventilation of the left (ventilator-induced lung injury) lung with tidal volume of approximately 3 mL/kg and 1) high positive end-expiratory pressure set above the level where dynamic compliance increased more than 5% during positive end-expiratory pressure trial (volutrauma); or 2) low positive end-expiratory pressure to achieve driving pressure comparable with volutrauma (atelectrauma). The right (control) lung was kept on continuous positive airway pressure of 20 cm H2O, and CO2 was partially removed extracorporeally. MEASUREMENTS AND MAIN
resultsRegional lung aeration, specific [F]fluorodeoxyglucose uptake rate, and perfusion were assessed using computed and positron emission tomography. Volutrauma yielded higher [F]fluorodeoxyglucose uptake rate in the ventilated lung compared with atelectrauma (median [interquartile range], 0.017 [0.014-0.025] vs 0.013 min [0.010-0.014 min]; p < 0.01), mainly in central lung regions. Volutrauma yielded higher [F]fluorodeoxyglucose uptake rate in ventilator-induced lung injury versus control lung (0.017 [0.014-0.025] vs 0.011 min [0.010-0.016 min]; p < 0.05), whereas atelectrauma did not. Volutrauma decreased blood fraction at similar perfusion and increased normally as well as hyperaerated lung compartments and tidal hyperaeration. Atelectrauma yielded higher poorly and nonaerated lung compartments, and tidal recruitment. Driving pressure increased in atelectrauma.
conclusionsIn this model of acute respiratory distress syndrome, volutrauma promoted higher lung inflammation than atelectrauma at comparable low tidal volume and lower driving pressure, suggesting that static stress and strain are major determinants of ventilator-induced lung injury.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.