Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model

Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. Additionally, there was a shift from non- and poorly-aerated lung tissue to normally-aerated lung tissue in FCV compared to PCV. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Abram, Julia [verfasserIn] Spraider, Patrick Wagner, Julian Putzer, Gabriel Ranalter, Manuela Rinner, Sarah Lindner, Andrea Katharina Glodny, Bernhard Hell, Tobias Barnes, Tom Enk, Dietmar Martini, Judith

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2024

Schlagwörter:	Flow-controlled ventilation Pressure-controlled ventilation Intra-abdominal hypertension Mechanical power Atelectasis

Anmerkung:	© The Author(s) 2024

Übergeordnetes Werk:	Enthalten in: Intensive Care Medicine Experimental - Berlin : SpringerOpen, 2013, 12(2024), 1 vom: 07. März
Übergeordnetes Werk:	volume:12 ; year:2024 ; number:1 ; day:07 ; month:03

Links:	Volltext

DOI / URN:	10.1186/s40635-024-00608-9

Katalog-ID:	SPR055062288

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520			\|a Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. Additionally, there was a shift from non- and poorly-aerated lung tissue to normally-aerated lung tissue in FCV compared to PCV.
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allfields	10.1186/s40635-024-00608-9 doi (DE-627)SPR055062288 (SPR)s40635-024-00608-9-e DE-627 ger DE-627 rakwb eng Abram, Julia verfasserin aut Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. Additionally, there was a shift from non- and poorly-aerated lung tissue to normally-aerated lung tissue in FCV compared to PCV. Flow-controlled ventilation (dpeaa)DE-He213 Pressure-controlled ventilation (dpeaa)DE-He213 Intra-abdominal hypertension (dpeaa)DE-He213 Mechanical power (dpeaa)DE-He213 Atelectasis (dpeaa)DE-He213 Spraider, Patrick (orcid)0000-0002-1605-6696 aut Wagner, Julian aut Putzer, Gabriel aut Ranalter, Manuela aut Rinner, Sarah aut Lindner, Andrea Katharina aut Glodny, Bernhard aut Hell, Tobias aut Barnes, Tom aut Enk, Dietmar aut Martini, Judith aut Enthalten in Intensive Care Medicine Experimental Berlin : SpringerOpen, 2013 12(2024), 1 vom: 07. März (DE-627)771394640 (DE-600)2740385-3 2197-425X nnns volume:12 year:2024 number:1 day:07 month:03 https://dx.doi.org/10.1186/s40635-024-00608-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2024 1 07 03
spelling	10.1186/s40635-024-00608-9 doi (DE-627)SPR055062288 (SPR)s40635-024-00608-9-e DE-627 ger DE-627 rakwb eng Abram, Julia verfasserin aut Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. Additionally, there was a shift from non- and poorly-aerated lung tissue to normally-aerated lung tissue in FCV compared to PCV. Flow-controlled ventilation (dpeaa)DE-He213 Pressure-controlled ventilation (dpeaa)DE-He213 Intra-abdominal hypertension (dpeaa)DE-He213 Mechanical power (dpeaa)DE-He213 Atelectasis (dpeaa)DE-He213 Spraider, Patrick (orcid)0000-0002-1605-6696 aut Wagner, Julian aut Putzer, Gabriel aut Ranalter, Manuela aut Rinner, Sarah aut Lindner, Andrea Katharina aut Glodny, Bernhard aut Hell, Tobias aut Barnes, Tom aut Enk, Dietmar aut Martini, Judith aut Enthalten in Intensive Care Medicine Experimental Berlin : SpringerOpen, 2013 12(2024), 1 vom: 07. März (DE-627)771394640 (DE-600)2740385-3 2197-425X nnns volume:12 year:2024 number:1 day:07 month:03 https://dx.doi.org/10.1186/s40635-024-00608-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2024 1 07 03
allfields_unstemmed	10.1186/s40635-024-00608-9 doi (DE-627)SPR055062288 (SPR)s40635-024-00608-9-e DE-627 ger DE-627 rakwb eng Abram, Julia verfasserin aut Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. Additionally, there was a shift from non- and poorly-aerated lung tissue to normally-aerated lung tissue in FCV compared to PCV. Flow-controlled ventilation (dpeaa)DE-He213 Pressure-controlled ventilation (dpeaa)DE-He213 Intra-abdominal hypertension (dpeaa)DE-He213 Mechanical power (dpeaa)DE-He213 Atelectasis (dpeaa)DE-He213 Spraider, Patrick (orcid)0000-0002-1605-6696 aut Wagner, Julian aut Putzer, Gabriel aut Ranalter, Manuela aut Rinner, Sarah aut Lindner, Andrea Katharina aut Glodny, Bernhard aut Hell, Tobias aut Barnes, Tom aut Enk, Dietmar aut Martini, Judith aut Enthalten in Intensive Care Medicine Experimental Berlin : SpringerOpen, 2013 12(2024), 1 vom: 07. März (DE-627)771394640 (DE-600)2740385-3 2197-425X nnns volume:12 year:2024 number:1 day:07 month:03 https://dx.doi.org/10.1186/s40635-024-00608-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2024 1 07 03
allfieldsGer	10.1186/s40635-024-00608-9 doi (DE-627)SPR055062288 (SPR)s40635-024-00608-9-e DE-627 ger DE-627 rakwb eng Abram, Julia verfasserin aut Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. Additionally, there was a shift from non- and poorly-aerated lung tissue to normally-aerated lung tissue in FCV compared to PCV. Flow-controlled ventilation (dpeaa)DE-He213 Pressure-controlled ventilation (dpeaa)DE-He213 Intra-abdominal hypertension (dpeaa)DE-He213 Mechanical power (dpeaa)DE-He213 Atelectasis (dpeaa)DE-He213 Spraider, Patrick (orcid)0000-0002-1605-6696 aut Wagner, Julian aut Putzer, Gabriel aut Ranalter, Manuela aut Rinner, Sarah aut Lindner, Andrea Katharina aut Glodny, Bernhard aut Hell, Tobias aut Barnes, Tom aut Enk, Dietmar aut Martini, Judith aut Enthalten in Intensive Care Medicine Experimental Berlin : SpringerOpen, 2013 12(2024), 1 vom: 07. März (DE-627)771394640 (DE-600)2740385-3 2197-425X nnns volume:12 year:2024 number:1 day:07 month:03 https://dx.doi.org/10.1186/s40635-024-00608-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2024 1 07 03
allfieldsSound	10.1186/s40635-024-00608-9 doi (DE-627)SPR055062288 (SPR)s40635-024-00608-9-e DE-627 ger DE-627 rakwb eng Abram, Julia verfasserin aut Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. Additionally, there was a shift from non- and poorly-aerated lung tissue to normally-aerated lung tissue in FCV compared to PCV. Flow-controlled ventilation (dpeaa)DE-He213 Pressure-controlled ventilation (dpeaa)DE-He213 Intra-abdominal hypertension (dpeaa)DE-He213 Mechanical power (dpeaa)DE-He213 Atelectasis (dpeaa)DE-He213 Spraider, Patrick (orcid)0000-0002-1605-6696 aut Wagner, Julian aut Putzer, Gabriel aut Ranalter, Manuela aut Rinner, Sarah aut Lindner, Andrea Katharina aut Glodny, Bernhard aut Hell, Tobias aut Barnes, Tom aut Enk, Dietmar aut Martini, Judith aut Enthalten in Intensive Care Medicine Experimental Berlin : SpringerOpen, 2013 12(2024), 1 vom: 07. März (DE-627)771394640 (DE-600)2740385-3 2197-425X nnns volume:12 year:2024 number:1 day:07 month:03 https://dx.doi.org/10.1186/s40635-024-00608-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2024 1 07 03
language	English
source	Enthalten in Intensive Care Medicine Experimental 12(2024), 1 vom: 07. März volume:12 year:2024 number:1 day:07 month:03
sourceStr	Enthalten in Intensive Care Medicine Experimental 12(2024), 1 vom: 07. März volume:12 year:2024 number:1 day:07 month:03
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Flow-controlled ventilation Pressure-controlled ventilation Intra-abdominal hypertension Mechanical power Atelectasis
isfreeaccess_bool	true
container_title	Intensive Care Medicine Experimental
authorswithroles_txt_mv	Abram, Julia @@aut@@ Spraider, Patrick @@aut@@ Wagner, Julian @@aut@@ Putzer, Gabriel @@aut@@ Ranalter, Manuela @@aut@@ Rinner, Sarah @@aut@@ Lindner, Andrea Katharina @@aut@@ Glodny, Bernhard @@aut@@ Hell, Tobias @@aut@@ Barnes, Tom @@aut@@ Enk, Dietmar @@aut@@ Martini, Judith @@aut@@
publishDateDaySort_date	2024-03-07T00:00:00Z
hierarchy_top_id	771394640
id	SPR055062288
language_de	englisch
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The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. 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author	Abram, Julia
spellingShingle	Abram, Julia misc Flow-controlled ventilation misc Pressure-controlled ventilation misc Intra-abdominal hypertension misc Mechanical power misc Atelectasis Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model
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topic_title	Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model Flow-controlled ventilation (dpeaa)DE-He213 Pressure-controlled ventilation (dpeaa)DE-He213 Intra-abdominal hypertension (dpeaa)DE-He213 Mechanical power (dpeaa)DE-He213 Atelectasis (dpeaa)DE-He213
topic	misc Flow-controlled ventilation misc Pressure-controlled ventilation misc Intra-abdominal hypertension misc Mechanical power misc Atelectasis
topic_unstemmed	misc Flow-controlled ventilation misc Pressure-controlled ventilation misc Intra-abdominal hypertension misc Mechanical power misc Atelectasis
topic_browse	misc Flow-controlled ventilation misc Pressure-controlled ventilation misc Intra-abdominal hypertension misc Mechanical power misc Atelectasis
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title	Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model
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title_full	Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model
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author_browse	Abram, Julia Spraider, Patrick Wagner, Julian Putzer, Gabriel Ranalter, Manuela Rinner, Sarah Lindner, Andrea Katharina Glodny, Bernhard Hell, Tobias Barnes, Tom Enk, Dietmar Martini, Judith
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title_sort	individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model
title_auth	Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model
abstract	Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. Additionally, there was a shift from non- and poorly-aerated lung tissue to normally-aerated lung tissue in FCV compared to PCV. © The Author(s) 2024
abstractGer	Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. Additionally, there was a shift from non- and poorly-aerated lung tissue to normally-aerated lung tissue in FCV compared to PCV. © The Author(s) 2024
abstract_unstemmed	Background Aim of this study was to evaluate feasibility and effects of individualised flow-controlled ventilation (FCV), based on compliance guided pressure settings, compared to standard of pressure-controlled ventilation (PCV) in a porcine intra-abdominal hypertension (IAH) model. The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. Additionally, there was a shift from non- and poorly-aerated lung tissue to normally-aerated lung tissue in FCV compared to PCV. © The Author(s) 2024
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title_short	Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model
url	https://dx.doi.org/10.1186/s40635-024-00608-9
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author2	Spraider, Patrick Wagner, Julian Putzer, Gabriel Ranalter, Manuela Rinner, Sarah Lindner, Andrea Katharina Glodny, Bernhard Hell, Tobias Barnes, Tom Enk, Dietmar Martini, Judith
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The primary aim of this study was to investigate oxygenation. Secondary aims were to assess respiratory and metabolic variables and lung tissue aeration. Methods Pigs were randomly assigned to FCV (n = 9) and PCV (n = 9). IAH was induced by insufflation of air into the abdomen to induce IAH grades ranging from 0 to 3. At each IAH grade FCV was undertaken using compliance guided pressure settings, or PCV (n = 9) was undertaken with the positive end-expiratory pressure titrated for maximum compliance and the peak pressure set to achieve a tidal volume of 7 ml/kg. Gas exchange, ventilator settings and derived formulas were recorded at two timepoints for each grade of IAH. Lung aeration was assessed by a computed tomography scan at IAH grade 3. Results All 18 pigs (median weight 54 kg [IQR 51–67]) completed the observation period of 4 h. Oxygenation was comparable at each IAH grade, but a significantly lower minute volume was required to secure normocapnia in FCV at all IAH grades (7.6 vs. 14.4, MD − 6.8 (95% CI − 8.5 to − 5.2) l/min; p < 0.001). There was also a significant reduction of applied mechanical power being most evident at IAH grade 3 (25.9 vs. 57.6, MD − 31.7 (95% CI − 39.7 to − 23.7) J/min; p < 0.001). Analysis of Hounsfield unit distribution of the computed tomography scans revealed a significant reduction in non- (5 vs. 8, MD − 3 (95% CI − 6 to 0) %; p = 0.032) and poorly-aerated lung tissue (7 vs. 15, MD − 6 (95% CI − 13 to − 3) %, p = 0.002) for FCV. Concomitantly, normally-aerated lung tissue was significantly increased (84 vs. 76, MD 8 (95% CI 2 to 15) %; p = 0.011). Conclusions Individualised FCV showed similar oxygenation but required a significantly lower minute volume for $ CO_{2} $-removal, which led to a remarkable reduction of applied mechanical power. 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Individualised flow-controlled ventilation reduces applied mechanical power and improves ventilation efficiency in a porcine intra-abdominal hypertension model

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