ArticleAnnals of biomedical engineering2026
Injury Mechanics in Surfactant-Depleted and Healthy Rat Lungs: A Multi-scale Consideration of Artificial and Physiological Ventilation.
Article in Annals of biomedical engineering, 2026. 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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Abstract
purposeVentilator-induced lung injury (VILI) causes regional pulmonary damage and remains a medical challenge. While the clinical standard, positive-pressure ventilation (PPV), has been contrasted with physiological negative-pressure ventilation (NPV), the discrepancy between ventilation modes on VILI remains unstudied.
methodsTo elucidate possible VILI mechanics from alveolar overdistension and distortion, three groups of rat lungs were examined: uninjured controls, lungs subjected to high tidal volume with zero positive end-expiratory pressure to induce VILI, denoted VILI-Only, and surfactant-depleted VILI lungs. PPV and NPV mechanics were continuously assessed at the organ- and tissue-level with a custom-designed electromechanical apparatus paired to digital image correlation, where confocal microscopy confirmed microstructural damage.
resultsCompared to controls, VILI-Only increased regional strain by 6% while static compliance remained similar. Surfactant-depleted VILI lungs exhibited greater strain and compliance increases, and both injury groups showed elevated strain anisotropy. In VILI-Only lungs, NPV compared to PPV, reduced mean strain (9%), anisotropic distortion, and hysteresis (25%) relative to PPV, while promoting more isotropic deformation in right lung lobes. In surfactant-depleted VILI lungs, NPV reduced inflation compliance relative to PPV, but did not lessen regional strain. Notably, NPV revealed greater pressure relaxation in VILI-Only, a non-observed effect with PPV.
conclusionAltogether, VILI-Only and surfactant-depleted VILI produced elevated strain and anisotropic deformation, indicating damaging regional inflation. NPV revealed more prominent alterations in lung behavior, including pressure relaxation and strain significances, indicating improved sensitivity to early dysfunction. In VILI-Only lungs, NPV also reduced strain and anisotropy, suggesting physiological breathing may mitigate progressive VILI-induced mechanical damage.
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