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Influence of end-expiratory level and tidal volume on gravitational ventilation distribution during tidal breathing in healthy adults

Schnidrig, Silvia ; Casaulta, Carmen ; Schibler, Andreas ; Riedel, Thomas

In: European Journal of Applied Physiology, 2013, vol. 113, no. 3, p. 591-598

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    Titre
    • Influence of end-expiratory level and tidal volume on gravitational ventilation distribution during tidal breathing in healthy adults
    Auteur
    • Schnidrig, Silvia. Division of Paediatric and Neonatal Intensive Care Medicine, Department of Paediatrics, Inselspital, University Children's Hospital and University of Bern, 3010, Bern, Switzerland
    • Casaulta, Carmen. Division of Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, University Children's Hospital and University of Bern, Bern, Switzerland
    • Schibler, Andreas. Paediatric Critical Care Research Group, Paediatric Intensive Care Unit, Mater Children's Hospital, South Brisbane, QLD, Australia
    • Riedel, Thomas. Division of Paediatric and Neonatal Intensive Care Medicine, Department of Paediatrics, Inselspital, University Children's Hospital and University of Bern, 3010, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Applied Physiology, 2013, vol. 113, no. 3, p. 591-598. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:319139
    Summary
    Our understanding of regional filling of the lung and regional ventilation distribution is based on studies using stepwise inhalation of radiolabelled tracer gases, magnetic resonance imaging and positron emission tomography. We aimed to investigate whether these differences in ventilation distribution at different end-expiratory levels (EELs) and tidal volumes (V Ts) held also true during tidal breathing. Electrical impedance tomography (EIT) measurements were performed in ten healthy adults in the right lateral position. Five different EELs with four different V Ts at each EEL were tested in random order, resulting in 19 combinations. There were no measurements for the combination of the highest EEL/highest V T. EEL and V T were controlled by visual feedback based on airflow. The fraction of ventilation directed to different slices of the lung (VENTRL1−VENTRL8) and the rate of the regional filling of each slice versus the total lung were analysed. With increasing EEL but normal tidal volume, ventilation was preferentially distributed to the dependent lung and the filling of the right and left lung was more homogeneous. With increasing V T and maintained normal EEL (FRC), ventilation was preferentially distributed to the dependent lung and regional filling became more inhomogeneous (p<0.05). We could demonstrate that regional and temporal ventilation distribution during tidal breathing was highly influenced by EEL and V T