Comparison of static end-expiratory and effective lung volumes for gas exchange in healthy and surfactant-depleted lungs

Gergely Albu, Mats Wallin, Magnus Hallbäck, Per Emtell, Andrew Wolf, Per Arne Lönnqvist, Sylvia Göthberg, F. Peták, Walid Habre

Research output: Contribution to journalArticle

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Abstract

Background: Effective lung volume (ELV) for gas exchange is a new measure that could be used as a real-time guide during controlled mechanical ventilation. The authors established the relationships of ELV to static end-expiratory lung volume (EELV) with varying levels of positive end-expiratory pressure (PEEP) in healthy and surfactant-depleted rabbit lungs. Methods: Nine rabbits were anesthetized and ventilated with a modified volume-controlled mode where periods of five consecutive alterations in inspiratory/expiratory ratio (1:2-1.5:1) were imposed to measure ELV from the corresponding carbon dioxide elimination traces. EELV and the lung clearance index were concomitantly determined by helium wash-out technique. Airway and tissue mechanics were assessed by using low-frequency forced oscillations. Measurements were collected at PEEP 0, 3, 6, and 9 cm H2O levels under control condition and after surfactant depletion by whole-lung lavage. Results: ELV was greater than EELV at all PEEP levels before lavage, whereas there was no evidence for a difference in the lung volume indices after surfactant depletion at PEEP 6 or 9 cm H2O. Increasing PEEP level caused significant parallel increases in both ELV and EELV levels, decreases in ventilation heterogeneity, and improvement in airway and tissue mechanics under control condition and after surfactant depletion. ELV and EELV exhibited strong and statistically significant correlations before (r = 0.84) and after lavage (r = 0.87). Conclusions: The parallel changes in ELV and EELV with PEEP in healthy and surfactant-depleted lungs support the clinical value of ELV measurement as a bedside tool to estimate dynamic changes in EELV in children and infants.

Original languageEnglish
Pages (from-to)101-110
Number of pages10
JournalAnesthesiology
Volume119
Issue number1
DOIs
Publication statusPublished - Jul 2013

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Surface-Active Agents
Gases
Lung
Positive-Pressure Respiration
Therapeutic Irrigation
Mechanics
Rabbits
Lung Volume Measurements
Helium
Bronchoalveolar Lavage
Artificial Respiration
Carbon Dioxide
Ventilation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Albu, G., Wallin, M., Hallbäck, M., Emtell, P., Wolf, A., Lönnqvist, P. A., ... Habre, W. (2013). Comparison of static end-expiratory and effective lung volumes for gas exchange in healthy and surfactant-depleted lungs. Anesthesiology, 119(1), 101-110. https://doi.org/10.1097/ALN.0b013e3182923c40

Comparison of static end-expiratory and effective lung volumes for gas exchange in healthy and surfactant-depleted lungs. / Albu, Gergely; Wallin, Mats; Hallbäck, Magnus; Emtell, Per; Wolf, Andrew; Lönnqvist, Per Arne; Göthberg, Sylvia; Peták, F.; Habre, Walid.

In: Anesthesiology, Vol. 119, No. 1, 07.2013, p. 101-110.

Research output: Contribution to journalArticle

Albu, G, Wallin, M, Hallbäck, M, Emtell, P, Wolf, A, Lönnqvist, PA, Göthberg, S, Peták, F & Habre, W 2013, 'Comparison of static end-expiratory and effective lung volumes for gas exchange in healthy and surfactant-depleted lungs', Anesthesiology, vol. 119, no. 1, pp. 101-110. https://doi.org/10.1097/ALN.0b013e3182923c40
Albu, Gergely ; Wallin, Mats ; Hallbäck, Magnus ; Emtell, Per ; Wolf, Andrew ; Lönnqvist, Per Arne ; Göthberg, Sylvia ; Peták, F. ; Habre, Walid. / Comparison of static end-expiratory and effective lung volumes for gas exchange in healthy and surfactant-depleted lungs. In: Anesthesiology. 2013 ; Vol. 119, No. 1. pp. 101-110.
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