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Related Experiment Videos

Biologically variable or naturally noisy mechanical ventilation recruits atelectatic lung.

W A Mutch1, S Harms, M Ruth Graham

  • 1Department of Anaesthesia and Neuroanaesthesia Research Laboratory, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. amutch@ms.umanitoba.ca

American Journal of Respiratory and Critical Care Medicine
|July 21, 2000
PubMed
Summary

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Biologically variable ventilation (Vbv) improved lung function in a porcine model of lung injury. This novel approach, mimicking natural breathing patterns, enhanced gas exchange and lung re-inflation compared to conventional methods.

Area of Science:

  • Critical Care Medicine
  • Respiratory Physiology
  • Biomedical Engineering

Background:

  • Biologically variable mechanical ventilation (Vbv) mimics spontaneous breathing variability.
  • Vbv is hypothesized to improve gas exchange in lung injury by promoting alveolar recruitment.
  • The variability in Vbv can be modeled as an inverse power law frequency distribution.

Purpose of the Study:

  • To compare the efficacy of Vbv in reinflating a collapsed lung versus conventional ventilation (Vc) and ventilation with sigh breaths (Vs).
  • To investigate the physiological effects of Vbv in a porcine model of atelectasis.

Main Methods:

  • A porcine model of atelectasis was used, involving right lung collapse with one-lung ventilation.
  • Seven pigs received Vbv, seven received Vc, and eight received Vs over a 5-hour period.

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  • Gas exchange, respiratory system compliance (Crs), and airway pressures were monitored.

    • Main Results:

    • Vbv significantly enhanced collapsed lung re-inflation, leading to higher PaO2, lower PaCO2, and reduced shunt fraction compared to Vc and Vs.
    • Vbv resulted in higher Crs and lower mean peak inspiratory airway pressures (Ppaw) than Vc and Vs.
    • Tidal volume increased by 11% with Vbv compared to Vc, and the programmed respiratory rate variability followed an inverse power law distribution.

    Conclusions:

    • Biologically variable mechanical ventilation (Vbv) is superior to conventional ventilation in improving gas exchange and lung re-inflation in a model of atelectasis.
    • The findings support the theoretical model of 'noisy' ventilation promoting better recruitment of collapsed lung tissue.
    • Vbv demonstrates enhanced performance in mechanical ventilation, suggesting potential clinical benefits for patients with lung injury.