Effects of Ultralow-Tidal-Volume Ventilation under Veno-Venous Extracorporeal Membrane Oxygenation in a Porcine Model with Ventilator-Induced Lung Injury
Low-tidal-volume ventilation decreases mortality in acute respiratory distress syndrome (ARDS) patients. This study investigated the effects of ultralow tidal ventilation under veno-venous extracorporeal membrane oxygenator (ECMO) support in pigs with ARDS. Eight pigs were intubated and inoculated w...
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| Format: | Article |
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MDPI AG
2020-11-01
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| Series: | Membranes |
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| Online Access: | https://www.mdpi.com/2077-0375/10/12/379 |
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| author | Sung Yoon Lim Young-Jae Cho Dong Jung Kim Jun Sung Kim Sanghoon Jheon Jin Haeng Chung Jae Ho Lee |
| author_facet | Sung Yoon Lim Young-Jae Cho Dong Jung Kim Jun Sung Kim Sanghoon Jheon Jin Haeng Chung Jae Ho Lee |
| author_sort | Sung Yoon Lim |
| collection | DOAJ |
| description | Low-tidal-volume ventilation decreases mortality in acute respiratory distress syndrome (ARDS) patients. This study investigated the effects of ultralow tidal ventilation under veno-venous extracorporeal membrane oxygenator (ECMO) support in pigs with ARDS. Eight pigs were intubated and inoculated with methicillin-resistant <i>Staphylococcus aureus</i> through bronchoscopy. Ultralow tidal ventilation (3 mL/kg) under extracorporeal membrane oxygenator (ECMO) support was applied to one group and high tidal ventilation (15 mL/kg) was applied to another group to maintain comparable oxygenation for 12 h without ECMO support. Each group had similar arterial blood gas values and hemodynamic variables at baseline and during the experiment. The high-tidal-volume ventilation group showed a gradual decline in arterial oxygen levels, and repeated ANOVA showed significant differences in oxygenation change over time in the ultralow tidal ventilation group. Inflammatory cytokine levels in the bronchoalveolar lavage fluid and lung ultrasound scores were similar between two groups. Histologic analysis showed that both groups developed pneumonia after 12 h; however, the ultralow tidal ventilation group had a lower lung injury score assessed by the pathologist. We developed the first ultralow-tidal-volume ventilation porcine model under veno-venous ECMO support. The ultralow-tidal-volume ventilation strategy can mitigate mechanical ventilator-associated lung injury. |
| first_indexed | 2024-03-10T14:29:41Z |
| format | Article |
| id | doaj.art-fc013a3011ad4089ad3b73e85d6453d3 |
| institution | Directory Open Access Journal |
| issn | 2077-0375 |
| language | English |
| last_indexed | 2024-03-10T14:29:41Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Membranes |
| spelling | doaj.art-fc013a3011ad4089ad3b73e85d6453d32023-11-20T22:45:22ZengMDPI AGMembranes2077-03752020-11-01101237910.3390/membranes10120379Effects of Ultralow-Tidal-Volume Ventilation under Veno-Venous Extracorporeal Membrane Oxygenation in a Porcine Model with Ventilator-Induced Lung InjurySung Yoon Lim0Young-Jae Cho1Dong Jung Kim2Jun Sung Kim3Sanghoon Jheon4Jin Haeng Chung5Jae Ho Lee6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, KoreaDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, KoreaDepartment of Cardiovascular and Thoracic Surgery, Seoul National University Bundang Hospital, Seongnam 13620, KoreaDepartment of Cardiovascular and Thoracic Surgery, Seoul National University Bundang Hospital, Seongnam 13620, KoreaDepartment of Cardiovascular and Thoracic Surgery, Seoul National University Bundang Hospital, Seongnam 13620, KoreaDepartment of Pathology, Seoul National University Bundang Hospital, Seongnam 13620, KoreaDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, KoreaLow-tidal-volume ventilation decreases mortality in acute respiratory distress syndrome (ARDS) patients. This study investigated the effects of ultralow tidal ventilation under veno-venous extracorporeal membrane oxygenator (ECMO) support in pigs with ARDS. Eight pigs were intubated and inoculated with methicillin-resistant <i>Staphylococcus aureus</i> through bronchoscopy. Ultralow tidal ventilation (3 mL/kg) under extracorporeal membrane oxygenator (ECMO) support was applied to one group and high tidal ventilation (15 mL/kg) was applied to another group to maintain comparable oxygenation for 12 h without ECMO support. Each group had similar arterial blood gas values and hemodynamic variables at baseline and during the experiment. The high-tidal-volume ventilation group showed a gradual decline in arterial oxygen levels, and repeated ANOVA showed significant differences in oxygenation change over time in the ultralow tidal ventilation group. Inflammatory cytokine levels in the bronchoalveolar lavage fluid and lung ultrasound scores were similar between two groups. Histologic analysis showed that both groups developed pneumonia after 12 h; however, the ultralow tidal ventilation group had a lower lung injury score assessed by the pathologist. We developed the first ultralow-tidal-volume ventilation porcine model under veno-venous ECMO support. The ultralow-tidal-volume ventilation strategy can mitigate mechanical ventilator-associated lung injury.https://www.mdpi.com/2077-0375/10/12/379acute respiratory distress syndromeventilator-induced lung injuryextracorporeal membrane oxygenation |
| spellingShingle | Sung Yoon Lim Young-Jae Cho Dong Jung Kim Jun Sung Kim Sanghoon Jheon Jin Haeng Chung Jae Ho Lee Effects of Ultralow-Tidal-Volume Ventilation under Veno-Venous Extracorporeal Membrane Oxygenation in a Porcine Model with Ventilator-Induced Lung Injury Membranes acute respiratory distress syndrome ventilator-induced lung injury extracorporeal membrane oxygenation |
| title | Effects of Ultralow-Tidal-Volume Ventilation under Veno-Venous Extracorporeal Membrane Oxygenation in a Porcine Model with Ventilator-Induced Lung Injury |
| title_full | Effects of Ultralow-Tidal-Volume Ventilation under Veno-Venous Extracorporeal Membrane Oxygenation in a Porcine Model with Ventilator-Induced Lung Injury |
| title_fullStr | Effects of Ultralow-Tidal-Volume Ventilation under Veno-Venous Extracorporeal Membrane Oxygenation in a Porcine Model with Ventilator-Induced Lung Injury |
| title_full_unstemmed | Effects of Ultralow-Tidal-Volume Ventilation under Veno-Venous Extracorporeal Membrane Oxygenation in a Porcine Model with Ventilator-Induced Lung Injury |
| title_short | Effects of Ultralow-Tidal-Volume Ventilation under Veno-Venous Extracorporeal Membrane Oxygenation in a Porcine Model with Ventilator-Induced Lung Injury |
| title_sort | effects of ultralow tidal volume ventilation under veno venous extracorporeal membrane oxygenation in a porcine model with ventilator induced lung injury |
| topic | acute respiratory distress syndrome ventilator-induced lung injury extracorporeal membrane oxygenation |
| url | https://www.mdpi.com/2077-0375/10/12/379 |
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