Evidence map›Paper›PMID 39630324›Full record

ArticleIntensive care medicine experimental2024

Effect of fluid and driving pressure on cyclical "on-off" flow of pulmonary microcirculation during mechanical ventilation.

Siyi Yuan, Xiangyu Chen, Liangyu Mi, Yi Chi, Haoping Huang, Bo Liu, Chaofu Yue, Zeming Zhao, Longxiang Su, Yun Long and 3 more

Abstract read
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In one paragraph

Article in Intensive care medicine experimental, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Siyi Yuan *Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 1 Shuaifuyuan, Beijing, China.
Xiangyu Chen *Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 1 Shuaifuyuan, Beijing, China.
Liangyu MiDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 1 Shuaifuyuan, Beijing, China.
Yi ChiDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 1 Shuaifuyuan, Beijing, China.
Haoping HuangDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 1 Shuaifuyuan, Beijing, China.
Bo LiuDepartment of Critical Care Medicine, Affiliated Hospital of Jining Medical University, Jining, China.
Chaofu YueDeparment of Intensive Care Unit, Qu Jing NO.1 Hospital, Qu Jing, Yun Nan, China.
Zeming ZhaoJiamusi Central Hospital, Jiamusi, Heilongjiang Province, China.
Longxiang SuDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 1 Shuaifuyuan, Beijing, China.
Yun LongDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 1 Shuaifuyuan, Beijing, China. icu_longyun@126.com.
Şakir AkinDepartment of Intensive Care, Erasmus MC University Hospital, Rotterdam, Netherlands.
Can InceDepartment of Intensive Care, Erasmus MC University Hospital, Rotterdam, Netherlands.
Huaiwu HeDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 1 Shuaifuyuan, Beijing, China. tjmuhhw@126.com.

Funding

National High-Level Hospital Clinical Research Funding 2022-PUMCH-D-005
6 · The paper itself

Abstract

objectivesThis study aimed to identify the cyclical "on-off" flow of pulmonary microcirculation during inspiration and expiration by sidestream dark field imaging (SDF) technology in vivo and investigate the effects of volume status and driving pressure on cyclical "on-off" flow of microcirculation.

methods24 ARDS-modeled rabbits were randomly divided into high-driving pressure group (HDP group) and low-driving pressure group (LDP group). Lung microcirculation measurements were performed using the SDF microscope at two timepoints (T1 CVP 2-4 mmHg, T2 CVP 8-10 mmHg). From T1 to T2, 10 ml/kg saline was infused to increase CVP. The cyclical "on-off" pulmonary microcirculation was quantitatively assessed by the change of microcirculation between expiration and inspiration.

resultsProportion of perfused vessels (PPV), microvascular flow index (MFI), perfused vessel density (PVD), and total vessel density (TVD) at expiration were significantly higher than inspiration in the HDP group. The HDP group has a higher ΔPPV and ΔPVD. After fluid loading, ΔPPV and ΔMFI decreased. TNF-α, IL-6, Ang-2, and vWF levels in the HDP group were higher. The HDP group also has a higher lung wet-weight/body weight ratio, lung wet-to-dry weight ratio, and more severe damage of pulmonary capillaries than the LDP group.

conclusionsThe difference in alveolar perfused microcirculation between inspiration and expiration defined as cyclical "on-off flow" can be detected. High driving pressure can enhance the cyclical "on-off" flow, and fluid loading can relieve it. High driving pressure can potentially cause injury to pulmonary capillaries due to the phenomenon of "on-off" flow, thereby exacerbating ARDS.

Identifiers

PMID39630324
PMCPMC11618265

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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.