ArticleCritical care (London, England)2025
CPAP improves regional lung strain rate and diaphragm velocity of relaxation in experimental self-inflicted lung injury.
Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- What I talk about when I talk about patient self-inflicted lung injury: an ultrastructural perspective.Intensive care medicine experimental · 2026Article
- CPAP and high-flow nasal oxygen also reduce lung, diaphragm, and accessory muscle injury in experimental self-inflicted lung injury.Scientific reports · 2026Article
- Patient Self-Inflicted Lung Injury in ARDS: From Physiological Concept to Clinical Syndrome.Journal of clinical medicine · 2026Review
- Association between controlled mechanical ventilation and systemic inflammation in acute hypoxemic respiratory failure: an observational cohort study.Critical care (London, England) · 2025Observational
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7 authors.
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Abstract
backgroundStrenuous respiratory effort has been proposed as a second hit in severe acute lung injury (ALI), introducing the concept of "patient self-inflicted lung injury" (P-SILI). In an experimental setting, noninvasive continuous positive airway pressure (CPAP) attenuates lung and diaphragmatic injury, but the underlying mechanisms remains elusive. Here we investigate the effects of noninvasive CPAP on global and regional lung strain and diaphragm velocity of contraction and relaxation in an experimental P-SILI model.
methodsLung injury was induced in Sprague Dawley rats through surfactant depletion followed by either three hours of standard oxygen therapy (Control group) or CPAP support (CPAP group). Subjects were assessed through inspiratory and expiratory muscle activation. Regional lung and diaphragmatic deformation amplitude (strain) and the rate of change (strain rate) maps were developed using a micro-computed tomography (µCT) scan. Morphometric tissue assessment was carried out to study biological damage.
resultsCompared with the Control group, the CPAP group resulted in: (1) higher SpO
conclusionsStandard oxygen therapy resulted in worse patterns of lung strain rate and diaphragm velocity of relaxation, consistent with P-SILI and load-induced diaphragm injury. CPAP resulted in improved lung function, decreased lung strain rate, and diaphragmatic relaxation velocity throughout the respiratory cycle. We conclude that CPAP promotes biomechanical protection in injured lungs and diaphragm, more noticeably during the expiratory phase.
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