Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)

作者： Martin Russ*1, Emilia Boerger*1, Philip von Platen2, Roland C. E. Francis1, Mahdi Taher1, Willehad Boemke1, Burkhard Lachmann1, Steffen Leonhardt2, Philipp A. Pickerodt1 1Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität zu Berlin and Berlin Institute of Health Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, 2Chair for Medical Information Technology,RWTH Aachen University

简介：

Overview

This study presents a reproducible model of experimental acute respiratory distress syndrome (ARDS) through surfactant washout and high tidal volume ventilation. The model is characterized by low recruitability, allowing for the investigation of various ventilation strategies.

Key Study Components

Area of Science

• Respiratory physiology
• Acute respiratory distress syndrome (ARDS)
• Ventilation strategies

Background

• The combination of surfactant washout and injurious ventilation reduces lung recruitability.
• This model closely mimics clinical situations, enhancing its relevance.
• It supports the exploration of new ventilation strategies.
• It does not require additional techniques, making it accessible for research.

Purpose of Study

• To develop a model for studying ventilation strategies in ARDS.
• To investigate the effects of low recruitability on lung injury.
• To facilitate the translation of experimental findings into clinical practice.

Methods Used

• Surfactant washout using 0.9% saline (35 mL/kg body weight, 37 °C).
• High tidal volume ventilation with low PEEP.
• Mechanical ventilation targeting specific carbon dioxide and oxygen saturation levels.
• Use of intravenous anesthesia and muscle relaxants as needed.

Main Results

• The model demonstrates reduced lung recruitability compared to exclusive surfactant washout models.
• It effectively simulates the clinical scenario of ARDS.
• New ventilation strategies can be experimentally investigated.
• The model is reproducible and straightforward to implement.

Conclusions

• This two-hit model is valuable for studying ARDS and ventilation strategies.
• It provides insights that may translate into clinical applications.
• The low recruitability aspect is crucial for understanding lung injury dynamics.

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