A lung computed tomography assessment of positive end-expiratory pressureinduced lung overdistention
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Clinical and Biomedical Research |
Texto Completo: | https://seer.ufrgs.br/index.php/hcpa/article/view/125244 |
Resumo: | OBJECTIVE: The aim of the present study was to establish the tomographic limit of lung overdistention in normal individuals as well as to assess positive end-expiratorypressure-induced overdistention and alveolar recruitment in patients with acute lung injury.MATERIALS AND METHODS: Lung distention was first determined in six healthy volunteers in whom computed tomographic sections were obtained at functionalresidual capacity and total lung capacity with a positive airway pressure of 30 cmH2O. Tomographic scans at zero end-expiratory pressure and positive end-expiratorypressure were performed in six patients with acute lung injury. Computed tomographies were performed from the apex to the diaphragm and lung volumes were quantified by the analysis of the density histograms.RESULTS: Analysis of the density histograms in healthy volunteers was monophasic with a peak at -791 ± 12 Housenfield units. In total lung capacity, lung volumeincreased by 79 ± 35% and the peak of lung density decreased to -886 ±26 Housenfield units. More than 70% of the increase in lung volume was located below-900 Housenfield units, suggesting that this value can be considered as the threshold separating normal aeration from overdistention. In patients with acute lung injury, atzero end-expiratory pressure the distribution of density histograms was either monophasic (n=3) or biphasic (n=3), with mean density of -319 ± 34 Housenfieldunits. With positive end-expiratory pressure application, lung volume increased by 47 ± 19%, while lung density decreased to -538 ± Housenfield units. Positive endexpiratory pressure induced a mean alveolar recruitment of 238 ±320 ml.CONCLUSIONS: The limit of overdistention in healthy individuals was -900 Housenfield units. This threshold can be used in patients with acute lung injury fordifferentiating alveolar recruitment from lung overdistention. |
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Clinical and Biomedical Research |
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A lung computed tomography assessment of positive end-expiratory pressureinduced lung overdistentionAvaliação por tomografia computadorizada da hiperdistensão pulmonar induzida por PEEP em indivíduos normais e em pacientes com insuficiência respiratória agudaLesão pulmonar agudasíndrome da angústia respiratória agudatomografia computadorizadarecrutamento alveolarhiperdistensãopressão expiratória final positivaAcute lung injuryacute respiratory distress syndromecomputerized tomographyalveolar recruitmenthyperdistensionpositive end-expiratory pressureOBJECTIVE: The aim of the present study was to establish the tomographic limit of lung overdistention in normal individuals as well as to assess positive end-expiratorypressure-induced overdistention and alveolar recruitment in patients with acute lung injury.MATERIALS AND METHODS: Lung distention was first determined in six healthy volunteers in whom computed tomographic sections were obtained at functionalresidual capacity and total lung capacity with a positive airway pressure of 30 cmH2O. Tomographic scans at zero end-expiratory pressure and positive end-expiratorypressure were performed in six patients with acute lung injury. Computed tomographies were performed from the apex to the diaphragm and lung volumes were quantified by the analysis of the density histograms.RESULTS: Analysis of the density histograms in healthy volunteers was monophasic with a peak at -791 ± 12 Housenfield units. In total lung capacity, lung volumeincreased by 79 ± 35% and the peak of lung density decreased to -886 ±26 Housenfield units. More than 70% of the increase in lung volume was located below-900 Housenfield units, suggesting that this value can be considered as the threshold separating normal aeration from overdistention. In patients with acute lung injury, atzero end-expiratory pressure the distribution of density histograms was either monophasic (n=3) or biphasic (n=3), with mean density of -319 ± 34 Housenfieldunits. With positive end-expiratory pressure application, lung volume increased by 47 ± 19%, while lung density decreased to -538 ± Housenfield units. Positive endexpiratory pressure induced a mean alveolar recruitment of 238 ±320 ml.CONCLUSIONS: The limit of overdistention in healthy individuals was -900 Housenfield units. This threshold can be used in patients with acute lung injury fordifferentiating alveolar recruitment from lung overdistention.OBJETIVO: O objetivo do presente estudo foi determinar o limite tomográfico da hiperdistensão pulmonar em indivíduos normais, bem como avaliar o recrutamentoe a hiperdistensão pulmonares induzidos pela pressão expiratória final positiva em pacientes com lesão pulmonar aguda.MATERIAIS E MÉTODOS: Inicialmente, o limite da hiperdistensão pulmonar foi determinado em seis voluntários sadios, nos quais tomografias computadorizadas espiraladas de tórax foram obtidas em capacidade residual funcional e em capacidadepulmonar total mais pressão positiva de 30 cm H2O. Posteriormente, foram avaliados seis pacientes com lesão pulmonar aguda nos quais as tomografias foram obtidas em zero de pressão expiratória final positiva e em pressão expiratória final positiva. As tomografias computadorizadas foram realizadas do ápex ao diafragma, e os volumes pulmonares quantificados por análise dos histogramas de densidade.RESULTADOS: A análise dos histogramas de densidade em voluntários sadios em capacidade residual funcional mostrou histogramas monofásicos, com um pico em-791 + 12 UH. Em capacidade pulmonar total, o volume pulmonar aumentou em 79 + 35% e o pico das densidades pulmonares caiu para -886 + 26 UH. Mais de 70% do aumento no volume pulmonar foi localizado abaixo de -900 UH, sugerindo que este valor possa ser definido como o limite da hiperdistensão. Os pacientes com lesão pulmonar aguda mostraram em zero de pressão expiratória final positiva uma distribuição monofásica (n=3) ou bifásica (n=3), com densidades pulmonares médias situadas em 319 + 34 UH. Com a aplicação de pressão expiratória final positiva, ovolume pulmonar aumentou em 47 + 19%, enquanto que as densidades pulmonares caíram para -538 + 171 UH. Pressão expiratória final positiva induziu um recrutamento alveolar de 320 + 160 ml e uma hiperdistensão de 238 + 320 ml.CONCLUSÕES: O limite de hiperdistensão em voluntários sadios foi de -900 UH. Este limite pode ser usado em pacientes com lesão pulmonar aguda para diferenciarrecrutamento alveolar de hiperdistensão pressão expiratória final positiva induzidos.HCPA/FAMED/UFRGS2022-06-14info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionPeer-reviewed ArticleAvaliado por Paresapplication/pdfhttps://seer.ufrgs.br/index.php/hcpa/article/view/125244Clinical & Biomedical Research; Vol. 19 No. 3 (1999): Revista HCPAClinical and Biomedical Research; v. 19 n. 3 (1999): Revista HCPA2357-9730reponame:Clinical and Biomedical Researchinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSporhttps://seer.ufrgs.br/index.php/hcpa/article/view/125244/85180http://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessR.R. Vieira, Silvia Puybasset, Louis Richecoeur, Jack Lu, Qin Cluzel, Philippe Gusman, Pablo Coriat, Pierre Rouby, Jean-Jacques 2022-09-16T16:32:52Zoai:seer.ufrgs.br:article/125244Revistahttps://www.seer.ufrgs.br/index.php/hcpaPUBhttps://seer.ufrgs.br/index.php/hcpa/oai||cbr@hcpa.edu.br2357-97302357-9730opendoar:2022-09-16T16:32:52Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.none.fl_str_mv |
A lung computed tomography assessment of positive end-expiratory pressureinduced lung overdistention Avaliação por tomografia computadorizada da hiperdistensão pulmonar induzida por PEEP em indivíduos normais e em pacientes com insuficiência respiratória aguda |
title |
A lung computed tomography assessment of positive end-expiratory pressureinduced lung overdistention |
spellingShingle |
A lung computed tomography assessment of positive end-expiratory pressureinduced lung overdistention R.R. Vieira, Silvia Lesão pulmonar aguda síndrome da angústia respiratória aguda tomografia computadorizada recrutamento alveolar hiperdistensão pressão expiratória final positiva Acute lung injury acute respiratory distress syndrome computerized tomography alveolar recruitment hyperdistension positive end-expiratory pressure |
title_short |
A lung computed tomography assessment of positive end-expiratory pressureinduced lung overdistention |
title_full |
A lung computed tomography assessment of positive end-expiratory pressureinduced lung overdistention |
title_fullStr |
A lung computed tomography assessment of positive end-expiratory pressureinduced lung overdistention |
title_full_unstemmed |
A lung computed tomography assessment of positive end-expiratory pressureinduced lung overdistention |
title_sort |
A lung computed tomography assessment of positive end-expiratory pressureinduced lung overdistention |
author |
R.R. Vieira, Silvia |
author_facet |
R.R. Vieira, Silvia Puybasset, Louis Richecoeur, Jack Lu, Qin Cluzel, Philippe Gusman, Pablo Coriat, Pierre Rouby, Jean-Jacques |
author_role |
author |
author2 |
Puybasset, Louis Richecoeur, Jack Lu, Qin Cluzel, Philippe Gusman, Pablo Coriat, Pierre Rouby, Jean-Jacques |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
R.R. Vieira, Silvia Puybasset, Louis Richecoeur, Jack Lu, Qin Cluzel, Philippe Gusman, Pablo Coriat, Pierre Rouby, Jean-Jacques |
dc.subject.por.fl_str_mv |
Lesão pulmonar aguda síndrome da angústia respiratória aguda tomografia computadorizada recrutamento alveolar hiperdistensão pressão expiratória final positiva Acute lung injury acute respiratory distress syndrome computerized tomography alveolar recruitment hyperdistension positive end-expiratory pressure |
topic |
Lesão pulmonar aguda síndrome da angústia respiratória aguda tomografia computadorizada recrutamento alveolar hiperdistensão pressão expiratória final positiva Acute lung injury acute respiratory distress syndrome computerized tomography alveolar recruitment hyperdistension positive end-expiratory pressure |
description |
OBJECTIVE: The aim of the present study was to establish the tomographic limit of lung overdistention in normal individuals as well as to assess positive end-expiratorypressure-induced overdistention and alveolar recruitment in patients with acute lung injury.MATERIALS AND METHODS: Lung distention was first determined in six healthy volunteers in whom computed tomographic sections were obtained at functionalresidual capacity and total lung capacity with a positive airway pressure of 30 cmH2O. Tomographic scans at zero end-expiratory pressure and positive end-expiratorypressure were performed in six patients with acute lung injury. Computed tomographies were performed from the apex to the diaphragm and lung volumes were quantified by the analysis of the density histograms.RESULTS: Analysis of the density histograms in healthy volunteers was monophasic with a peak at -791 ± 12 Housenfield units. In total lung capacity, lung volumeincreased by 79 ± 35% and the peak of lung density decreased to -886 ±26 Housenfield units. More than 70% of the increase in lung volume was located below-900 Housenfield units, suggesting that this value can be considered as the threshold separating normal aeration from overdistention. In patients with acute lung injury, atzero end-expiratory pressure the distribution of density histograms was either monophasic (n=3) or biphasic (n=3), with mean density of -319 ± 34 Housenfieldunits. With positive end-expiratory pressure application, lung volume increased by 47 ± 19%, while lung density decreased to -538 ± Housenfield units. Positive endexpiratory pressure induced a mean alveolar recruitment of 238 ±320 ml.CONCLUSIONS: The limit of overdistention in healthy individuals was -900 Housenfield units. This threshold can be used in patients with acute lung injury fordifferentiating alveolar recruitment from lung overdistention. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-06-14 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Peer-reviewed Article Avaliado por Pares |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://seer.ufrgs.br/index.php/hcpa/article/view/125244 |
url |
https://seer.ufrgs.br/index.php/hcpa/article/view/125244 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://seer.ufrgs.br/index.php/hcpa/article/view/125244/85180 |
dc.rights.driver.fl_str_mv |
http://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
HCPA/FAMED/UFRGS |
publisher.none.fl_str_mv |
HCPA/FAMED/UFRGS |
dc.source.none.fl_str_mv |
Clinical & Biomedical Research; Vol. 19 No. 3 (1999): Revista HCPA Clinical and Biomedical Research; v. 19 n. 3 (1999): Revista HCPA 2357-9730 reponame:Clinical and Biomedical Research instname:Universidade Federal do Rio Grande do Sul (UFRGS) instacron:UFRGS |
instname_str |
Universidade Federal do Rio Grande do Sul (UFRGS) |
instacron_str |
UFRGS |
institution |
UFRGS |
reponame_str |
Clinical and Biomedical Research |
collection |
Clinical and Biomedical Research |
repository.name.fl_str_mv |
Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS) |
repository.mail.fl_str_mv |
||cbr@hcpa.edu.br |
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1799767056902520832 |