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The link between regional tidal stretch and lung injury during mechanical ventilation


Yen, S and Preissner, M and Bennett, E and Dubsky, S and Carnibella, R and O'Toole, R and Roddam, L and Jones, H and Dargaville, PA and Fouras, A and Zosky, GR, The link between regional tidal stretch and lung injury during mechanical ventilation, American Journal of Respiratory Cell and Molecular Biology pp. 1-35. ISSN 1535-4989 (2018) [Refereed Article]

Copyright Statement

Copyright 2019 American Thoracic Society

DOI: doi:10.1165/rcmb.2018-0143OC


Aim: This study aimed to assess the association between regional tidal volume (VT), regional functional residual capacity (FRC) and the expression of genes linked with ventilator-induced lung injury.

Methods: Two groups of BALB/c mice (n = 8 per group) were ventilated for 2 h using a protective or injurious ventilation strategy, with free-breathing mice as controls. Regional VT and FRC of the ventilated mice was determined from analysis of high-resolution four-dimensional computed tomography (4D-CT) images, taken at baseline and after 2 h of ventilation and corrected for the volume of the region (i.e. specific [s]Vt and specific [s]FRC). RNA levels of 21 genes in ten different lung regions were quantified using qPCR array.

Results: sFRC at baseline varied regionally, independent of ventilation strategy, whereas sVT varied regionally depending on ventilation strategy. The expression of IL-6 (P = 0.04), Ccl2 (P < 0.01) and Ang 2 (P < 0.05) were associated with sVT but not sFRC. The expression of seven other genes varied regionally (IL-1β and RAGE) or depended on ventilation strategy (Nfe2l2, c-fos and Wnt1) or both (TNF-α and CxCl2), but were not associated with regional sFRC or sVT.

Conclusion: These observations suggest that regional inflammatory responses to mechanical ventilation are primarily driven by tidal stretch.

Item Details

Item Type:Refereed Article
Keywords:tidal stretch, lung injury, mechanical ventilation
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Respiratory Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Respiratory System and Diseases (incl. Asthma)
UTAS Author:Yen, S (Mr Seiha Yen)
UTAS Author:Bennett, E (Ms Ellen Bennett)
UTAS Author:O'Toole, R (Dr Ronan O'Toole)
UTAS Author:Roddam, L (Dr Louise Roddam)
UTAS Author:Dargaville, PA (Professor Peter Dargaville)
UTAS Author:Zosky, GR (Professor Graeme Zosky)
ID Code:129877
Year Published:2018
Web of Science® Times Cited:2
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-12-20
Last Modified:2019-03-18

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