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Phase-Resolved Functional Lung MRI for Pulmonary Ventilation and Perfusion (V/Q) Assessment

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Regional lung volume changes during high-frequency oscillatory ventilation.

Gerhard K Wolf¹, Bartłomiej Grychtol, Inez Frerichs

¹Division of Critical Care Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA. gerhard.wolf@childrens.harvard.edu

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

|July 3, 2010

Summary

This summary is machine-generated.

High-frequency oscillatory ventilation (HFOV) during lung recruitment maneuvers shifts ventilation towards dependent lung areas, potentially causing overdistension in nondependent regions. This shift correlates with improved oxygenation efficiency, as indicated by reduced shunt fraction.

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Published on: June 5, 2019

Area of Science:

Critical Care Medicine
Respiratory Physiology
Medical Imaging

Background:

Lung injury impairs ventilation distribution.
High-frequency oscillatory ventilation (HFOV) is used in critical care.
Understanding regional ventilation during HFOV is crucial for optimizing lung protection.

Purpose of the Study:

To investigate regional lung volume changes during an inflation-deflation maneuver using HFOV.
To correlate the distribution of ventilation with oxygenating efficiency.

Main Methods:

Prospective animal study using Yorkshire swine.
Electrical impedance tomography (EIT) quantified regional ventilation.
Lung injury induced by surfactant lavage.
Inflation-deflation maneuvers performed by altering mean airway pressure during HFOV.

Main Results:

Lung injury shifted ventilation to nondependent areas and increased shunt fraction.
HFOV inflation shifted ventilation to dependent areas, correlating with shunt fraction.
Nondependent lung areas showed signs of overdistension, while dependent areas showed recruitment during inflation-deflation.

Conclusions:

The center of ventilation during HFOV correlates with oxygenating efficiency (shunt fraction).
Lung recruitment maneuvers during HFOV redistribute ventilation, potentially causing overdistension in nondependent lung regions and recruitment in dependent regions.