Regional Gas Transport During Conventional and Oscillatory Ventilation Assessed by Xenon-Enhanced Computed Tomography

Jacob Herrmann; Sarah E Gerard; Joseph M Reinhardt; Eric A Hoffman; David W Kaczka

doi:10.1007/s10439-021-02767-2

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Regional Gas Transport During Conventional and Oscillatory Ventilation Assessed by Xenon-Enhanced Computed Tomography

Journal article

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Regional Gas Transport During Conventional and Oscillatory Ventilation Assessed by Xenon-Enhanced Computed Tomography

Jacob Herrmann, Sarah E Gerard, Joseph M Reinhardt, Eric A Hoffman and David W Kaczka

Annals of biomedical engineering, Vol.49(9), pp.2377-2388

05/04/2021

DOI: 10.1007/s10439-021-02767-2

PMCID: PMC8796295

PMID: 33948747

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https://www.ncbi.nlm.nih.gov/pmc/articles/8796295View

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Abstract

Enhanced intrapulmonary gas transport enables oscillatory ventilation modalities to support gas exchange using extremely low tidal volumes at high frequencies. However, it is unknown whether gas transport rates can be improved by combining multiple frequencies of oscillation simultaneously. The goal of this study was to investigate distributed gas transport in vivo during multi-frequency oscillatory ventilation (MFOV) as compared with conventional mechanical ventilation (CMV) or high-frequency oscillatory ventilation (HFOV). We hypothesized that MFOV would result in more uniform rates of gas transport compared to HFOV, measured using contrast-enhanced CT imaging during wash-in of xenon gas. In 13 pigs, xenon wash-in equilibration rates were comparable between CMV and MFOV, but 21 to 39% slower for HFOV. By contrast, the root-mean-square delivered volume was lowest for MFOV, increased by 70% during HFOV and 365% during CMV. Overall gas transport heterogeneity was similar across all modalities, but gravitational gradients and regional patchiness of specific ventilation contributed to regional ventilation heterogeneity, depending on ventilator modality. We conclude that MFOV combines benefits of low lung stretch, similar to HFOV, but with fast rates of gas transport, similar to CMV.

Respiratory-gated imaging techniques

Mechanical ventilation

Pulmonary gas exchange

High-frequency ventilation

Details

Title: Subtitle: Regional Gas Transport During Conventional and Oscillatory Ventilation Assessed by Xenon-Enhanced Computed Tomography
Creators: Jacob Herrmann - University of Iowa
Sarah E Gerard - University of Iowa
Joseph M Reinhardt - University of Iowa
Eric A Hoffman - University of Iowa
David W Kaczka - University of Iowa
Resource Type: Journal article
Publication Details: Annals of biomedical engineering, Vol.49(9), pp.2377-2388
DOI: 10.1007/s10439-021-02767-2
PMID: 33948747
PMCID: PMC8796295
NLM abbreviation: Ann Biomed Eng
ISSN: 0090-6964
eISSN: 1573-9686
Grant note: R01 HL142625 / NHLBI NIH HHS W81XWH-16-1-0434 / U.S. Department of Defense 1S10OD018526 / NIH HHS R41 HL140640 / NHLBI NIH HHS
Language: English
Date published: 05/04/2021
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Anesthesia; Internal Medicine
Record Identifier: 9984197148602771

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