2024
Mechanical ventilation guided by driving pressure optimizes local pulmonary biomechanics in an ovine model
Lagier D, Zeng C, Kaczka D, Zhu M, Grogg K, Gerard S, Reinhardt J, Ribeiro G, Rashid A, Winkler T, Vidal Melo M. Mechanical ventilation guided by driving pressure optimizes local pulmonary biomechanics in an ovine model. Science Translational Medicine 2024, 16: eado1097. PMID: 39141699, DOI: 10.1126/scitranslmed.ado1097.Peer-Reviewed Original ResearchConceptsPositive end-expiratory pressureMechanical ventilationFour-dimensional computed tomographyParenchymal strainsVentilator-induced lung injuryAcute respiratory distress syndromeRespiratory system driving pressureManagement of mechanical ventilationPositive end-expiratory pressure valuesRespiratory distress syndromeTidal overdistensionEnd-expiratory pressureAssociated with mortalityPulmonary complicationsLung biomechanicsLung massDistress syndromeClinical outcomesLung injuryComputed tomographyClinical managementGeneral anesthesiaLung collapseDriving pressureLung
2023
Dynamic lung aeration and strain with positive end-expiratory pressure individualized to maximal compliance versus ARDSNet low-stretch strategy: a study in a surfactant depletion model of lung injury
Zeng C, Zhu M, Motta-Ribeiro G, Lagier D, Hinoshita T, Zang M, Grogg K, Winkler T, Vidal Melo M. Dynamic lung aeration and strain with positive end-expiratory pressure individualized to maximal compliance versus ARDSNet low-stretch strategy: a study in a surfactant depletion model of lung injury. Critical Care 2023, 27: 307. PMID: 37537654, PMCID: PMC10401825, DOI: 10.1186/s13054-023-04591-7.Peer-Reviewed Original ResearchConceptsAcute respiratory distress syndromeFour-dimensional computed tomographyPEEP strategyLung aerationEnd-inspirationLung injuryTidal recruitmentComputed tomographyRegistration-based techniqueEnd-expirationCyclic recruitmentMechanisms of ventilator-induced lung injuryVentilator-induced lung injuryPotential outcome benefitsBackgroundPositive end-expiratory pressureRespiratory distress syndromeHigh-resolution CTRespiratory system complianceEnd-expiratory pressureSaline lung lavageLung massDistress syndromeInspiratory increaseRecruitable lungSurfactant depletion model
2020
Lung Atelectasis Promotes Immune and Barrier Dysfunction as Revealed by Transcriptome Sequencing in Female Sheep.
Zeng C, Motta-Ribeiro G, Hinoshita T, Lessa M, Winkler T, Grogg K, Kingston N, Hutchinson J, Sholl L, Fang X, Varelas X, Layne M, Baron R, Vidal Melo M. Lung Atelectasis Promotes Immune and Barrier Dysfunction as Revealed by Transcriptome Sequencing in Female Sheep. Anesthesiology 2020, 133: 1060-1076. PMID: 32796202, PMCID: PMC7572680, DOI: 10.1097/aln.0000000000003491.Peer-Reviewed Original ResearchConceptsAlveolar-capillary barrier functionInterferon-stimulated genesImmune responseLung atelectasisAerated lungBarrier functionAerated lung regionsPulmonary transcriptomeSystemic lipopolysaccharideYes-associated protein signalingPulmonary atelectasisGene set enrichment analysisSystemic inflammationBronchial blockerLung injuryRight lungBarrier dysfunctionComputed tomographyLipopolysaccharide exposureAtelectasisLipopolysaccharide infusionAbsolute fold changeYes-associated proteinAtelectatic lungLung
2018
Deterioration of Regional Lung Strain and Inflammation during Early Lung Injury
Motta-Ribeiro G, Hashimoto S, Winkler T, Baron R, Grogg K, Paula L, Santos A, Zeng C, Hibbert K, Harris R, Bajwa E, Vidal Melo M. Deterioration of Regional Lung Strain and Inflammation during Early Lung Injury. American Journal Of Respiratory And Critical Care Medicine 2018, 198: 891-902. PMID: 29787304, PMCID: PMC6173064, DOI: 10.1164/rccm.201710-2038oc.Peer-Reviewed Original ResearchMeSH KeywordsAcute Lung InjuryAnalysis of VarianceAnimalsBiopsy, NeedleBlood Gas AnalysisDisease Models, AnimalEndotoxemiaEndotoxinsFemaleFluorodeoxyglucose F18HumansImmunohistochemistryInfusions, IntravenousLinear ModelsMultivariate AnalysisPositron-Emission TomographyPulmonary AtelectasisRandom AllocationRespiration, ArtificialRespiratory Distress SyndromeRespiratory Function TestsRisk FactorsSheepTidal VolumeTime FactorsTomography, X-Ray ComputedConceptsLung injurySupine lungConsistent with clinical practiceBlood volumeF-FDG phosphorylation rateLocal neutrophilic inflammationAssociated with increased inflammationF-FDG uptakeEarly mechanical ventilationClinical practiceEarly lung injuryPositive end-expiratory pressureLung strainEnd-expiratory pressurePositron emission tomographyF-FDGUninjured lungsImaging findingsRegional inflammationNeutrophilic inflammationSystemic endotoxemiaProne positionComputed tomographyVentilated patientsIntravenous endotoxin