U. Goebel, J. Haberstroh, K. Foerster, C. Dassow, H. -J. Priebe, J

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Presentation transcript:

Flow-controlled expiration: a novel ventilation mode to attenuate experimental porcine lung injury U. Goebel, J. Haberstroh, K. Foerster, C. Dassow, H.-J. Priebe, J. Guttmann, S. Schumann British Journal of Anaesthesia Volume 113, Issue 3, Pages 474-483 (September 2014) DOI: 10.1093/bja/aeu058 Copyright © 2014 The Author(s) Terms and Conditions

Fig 1 Representative diagrams of flow (a and b), volume (c and d), and airway pressure curves (e and f) in one animal each during ventilation with VCV (a, c, and e) and VCV+flow-controlled expiration (VCV+FLEX) (b, d, and f). Solid vertical lines indicate end-inspiration. Inspiratory curves were comparable during both conditions. During expiration, decreases in peak flow (b), volume (d), and airway pressure (f) were slower during ventilation with VCV+FLEX compared with VCV. British Journal of Anaesthesia 2014 113, 474-483DOI: (10.1093/bja/aeu058) Copyright © 2014 The Author(s) Terms and Conditions

Fig 2 Inspired oxygen fraction ( F I O 2 ). Data are presented as box plots, displaying median, 25–75 percentiles, and full range. VCV, volume-controlled ventilation; FLEX, flow-controlled expiration. There was no significant difference between the groups (P=0.978). British Journal of Anaesthesia 2014 113, 474-483DOI: (10.1093/bja/aeu058) Copyright © 2014 The Author(s) Terms and Conditions

Fig 3 (a) Wet-to-dry ratios in ventral and dorsal parts of the lungs. (b) Lung injury scores according to the American Thoracic Society scoring system. Data are presented as box plots, displaying median, 25–75 percentiles, and full range. VCV, volume-controlled ventilation; FLEX, flow-controlled expiration. ***P<0.001. British Journal of Anaesthesia 2014 113, 474-483DOI: (10.1093/bja/aeu058) Copyright © 2014 The Author(s) Terms and Conditions

Fig 4 (a) Representative lung tissue staining for measurement of alveolar wall thickness in ventral and dorsal lung areas. (b) Summary data of alveolar wall thickness. Data are presented as box plots, displaying median, 25–75 percentiles, and full range. VCV, volume-controlled ventilation; FLEX, flow-controlled expiration. ***P<0.001. British Journal of Anaesthesia 2014 113, 474-483DOI: (10.1093/bja/aeu058) Copyright © 2014 The Author(s) Terms and Conditions

Fig 5 (a) Representative lung tissue staining for alveolar macrophage count in ventral and dorsal lung areas. (b) Summary data of alveolar macrophage counts were derived from counts in 10 randomly chosen fields of vision in each of eight lung biopsies in ventral and dorsal areas. Data are presented as box plots, displaying median, 25–75 percentiles, and full range. VCV, volume-controlled ventilation; FLEX, flow-controlled expiration. ***P<0.001. British Journal of Anaesthesia 2014 113, 474-483DOI: (10.1093/bja/aeu058) Copyright © 2014 The Author(s) Terms and Conditions