Comparison of pressure, volume and gas washout characteristics between PCV and HFPV in healthy and formalin fixed <i>ex vivo</i> porcine lungs

Dutta, Rabijit; Xing, Tao; Murdoch, Gordon K.

doi:10.1088/1361-6579/aada73

Cited by 3 publications

(3 citation statements)

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“…Mechanical ventilation of the ex vivo porcine lung is physically feasible when an airway is introduced into the trachea and sealed to create a closed circuit in series with a pump (mechanical ventilator). [12][13][14] Over the past decade, there have been multiple investigations regarding the ex vivo perfusion of lungs to provide insight on donor lung preservation and management to improve organ availability for those in need of lung transplantation; the ex vivo ventilation of the pig lungs in these lung perfusion studies has been conducted successfully for both volume and pressure control modes of mechanical ventilation. 15…”

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

Impact of Breathing Pattern and Nebulization on Expelled Viral Content During Mechanical Ventilation Using an Ex Vivo Porcine Lung System

et al. 2022

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BACKGROUND: Little is known about the fate of expelled viral particulates during the aerosolization of inhaled medications during mechanical ventilation. We hypothesized that breathing patterns that generate a greater degree of shear stress and turbulent air flow will produce a greater concentration of exhaled viral RNA with the presence of a nebulizer during mechanical ventilation. METHODS: Eight ex vivo pig lungs were utilized as the physiological model. Each lung was dedicated to a specific breathing pattern that consisted of tidal breathing, respiratory distress, cough, and sneeze. Breath simulations were carried out through a commercial mechanical ventilator. Ninety mL of a bacteriophage stock at a concentration of 10 8 PFU/mL were introduced into the lungs during a 10-min sample collection session. The number of viral particles collected in exhalate was measured using quantitative polymerase chain reaction. The impact of breathing pattern on measured viruses was analyzed through two-way analysis of variance. RESULTS: The interaction effect between nebulization and breath pattern on exhaled viral quantity was not statistically significant P 5 .80, partial g 2 5 0.167. The analysis of the main effects indicated that the effects of the breathing pattern and nebulization phase were not statistically significant P 5 .26, partial g 2 5 0.519; P 5 .98, partial g 2 5 0, respectively. There were no statistically significant differences among the breathing patterns related to measurable viral RNA. Coughing produced the most measurable increase in measured viral quantity during the nebulization phase and non-nebulization phase with a mean exhaled viral quantity (3.5 3 10 5 ng/lL [95%

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Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

Impact of Breathing Pattern and Nebulization on Expelled Viral Content During Mechanical Ventilation Using an Ex Vivo Porcine Lung System

et al. 2022

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“…The effects of HFPV on nitrogen washout were studied in an ex-vivo model of adult porcine lungs with normal or low compliance using a HFPV-high (51). Compared to CMV, both HFPV strategies resulted in similar washout rates as CMV, but at a much lower VT and mean airway pressure (51).…”

Section: Animal Studiesmentioning

confidence: 99%

A narrative review of advanced ventilator modes in the pediatric intensive care unit

Miller¹,

Bartle²,

Feldman³

et al. 2021

Transl Pediatr

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Respiratory failure is a common reason for pediatric intensive care unit admission. The vast majority of children requiring mechanical ventilation can be supported with conventional mechanical ventilation (CMV) but certain cases with refractory hypoxemia or hypercapnia may require more advanced modes of ventilation. This paper discusses what we have learned about the use of advanced ventilator modes [e.g., high-frequency oscillatory ventilation (HFOV), high-frequency percussive ventilation (HFPV), high-frequency jet ventilation (HFJV) airway pressure release ventilation (APRV), and neurally adjusted ventilatory assist (NAVA)] from clinical, animal, and bench studies. The evidence supporting advanced ventilator modes is weak and consists of largely of single center case series, although a few RCTs have been performed. Animal and bench models illustrate the complexities of different modes and the challenges of applying these clinically. Some modes are proprietary to certain ventilators, are expensive, or may only be available at well-resourced centers. Future efforts should include large, multicenter observational, interventional, or adaptive design trials of different rescue modes (e.g., PROSpect trial), evaluate their use during ECMO, and should incorporate assessments through volumetric capnography, electric impedance tomography, and transpulmonary pressure measurements, along with precise reporting of ventilator parameters and physiologic variables.

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“…(9)(10)(11)22) Já os modelos pulmonares ex vivo tem outra abordagem, uma vez que os pulmões estão fora da caixa torácica e são mantidos em ambiente externo, necessitando preservação, mas são muito úteis para estudos de diferentes naturezas. (23)(24)(25)(26) Nesse contexto, o objetivo foi desenvolver um modelo pulmonar suíno ex vivo que demonstre as principais alterações da mecânica pulmonar e possa ser um modelo para outros estudos. Desta forma, optamos por seguir duas vertentes neste trabalho: Modelos Pulmonar ex vivo para o Ensino e Modelos Pulmonar ex vivo para a Pesquisa.…”

Section: Introductionunclassified

Modelo pulmonar suíno \"ex vivo\" para estudo e pesquisa de mecânica pulmonar

Egusquiza

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Comparison of pressure, volume and gas washout characteristics between PCV and HFPV in healthy and formalin fixed ex vivo porcine lungs

Abstract: The ex vivo study supports the hypothesis that in low compliant lungs HFPV provides effective washout with a protective ventilation.

Cited by 3 publications

References 24 publications

Impact of Breathing Pattern and Nebulization on Expelled Viral Content During Mechanical Ventilation Using an Ex Vivo Porcine Lung System

Impact of Breathing Pattern and Nebulization on Expelled Viral Content During Mechanical Ventilation Using an Ex Vivo Porcine Lung System

A narrative review of advanced ventilator modes in the pediatric intensive care unit

Modelo pulmonar suíno \"ex vivo\" para estudo e pesquisa de mecânica pulmonar

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