Comparison of recruitability of acute respiratory distress syndrome caused by pulmonary and extrapulmonary in pig models

doi:10.3877/cma.j.issn.2096-1537.2021.02.011

Abstract

Abstract:

Objective

To compare the recruitability between pulmonary (ARDSp) and extrapulmonary acute respiratory distress syndrome (ARDSexp) using electric impedance tomography (EIT) in pig models.

Methods

Sixteen healthy Bama pigs were randomly divided into ARDSp and ARDSexp group with 8 animals each. ARDSp model was established using alveolar instillation of hydrochloric acid and ARDSexp was injected with oleic acid through atrium venous. After the model was established, the animal received lung protective ventilation. After a recruitment maneuver, low (5 cmH₂O) and high (25 cmH₂O) PEEP were applied in each animal remaining other setting unchanged for 1 hour. Then an end-inspiratory and end-expiratory occlusion were performed. The recruitment volume (V_REC) generated between high and low PEEP was calculated, and the data of oxygenation and hemodynamic were recorded.

Results

Significant difference was found in V_REC between ARDSexp and ARDSp models (P=0.003), and V_REC was (1572.8±314.9) ml and (1089.9±224.2) ml, respectively. The ratio of arterial partial pressure of oxygen to inspired oxygen fraction (PaO₂/FiO₂) increased from (214.3±128.6) mmHg to (447.5±96.0) mmHg (P=0.004) with increasing PEEP in ARDSexp. However, PaO₂/FiO₂ did not change significantly in ARDSp [(173.6±112.0) mmHg vs (178.4±128.2) mmHg, P=0.943].

Conclusion

The recruitability between ARDSp and ARDSexp in pig models is different. Compared with ARDSp, ARDSexp may have better recruitability. Higher PEEP may improve the oxygenation of ARDSexp, while the effect on ARDSp is relatively small.

Key words: Pulmonary acute respiratory distress syndrome, Extrapulmonary acute respiratory distress syndrome, Recruitability, Recruitment volume, Electric impedance tomography

Yumei Wang, Yanlin Yang, Xiumei Sun, Yimin Zhou, Jingran Chen, Kunming Cheng, Hongliang Li, Jianxin. Zhou. Comparison of recruitability of acute respiratory distress syndrome caused by pulmonary and extrapulmonary in pig models[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2021, 07(02): 153-158.

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References 22

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指标	ARDSexp（8只）				ARDSp（8只）
指标	造模前	造模后	t值	P值	造模前	造模后	t值	P值
氧合指数（mmHg）	401.6±69.9	147.7±8.2	2.555	0.008	437.0±81.0	196.1±68.0	6.775	＜0.001
平均动脉压（mmHg）	127.4±12.6	103.1±20.5	0.049	0.008	110.5±21.8	110.0±9.7	2.527	0.962
心率（次/分）	51.3±9.4	70.0±23.2	1.977	0.089	48.9±6.9	60.1±23.4	2.106	0.039
MPAP（mmHg）	17.9±1.5	30.3±4.0	2.530	0.008	22.1±2.5	31.5±4.0	7.753	＜0.001
PAWP（mmHg）	7.0±1.8	7.9±4.0	0.106	1.000	10.9±0.8	12.8±2.3	2.311	0.054
CO（L/min）	3.2±2.3	2.1±0.4	1.552	0.148	2.7±0.5	2.8±0.6	0.580	0.580
平台压（cmH₂O）	9.9±1.2	13.2±2.3	5.137	0.001	11.4±1.6	17.6±1.8	20.316	＜0.001
Crs（ml/cmH₂O）	53.6±13.0	37.0±16.3	5.638	＜0.001	43.6±10.0	24.6±2.9	2.527	0.008
Crs-nondep（ml/cmH₂O）	39.0±11.6	28.5±14.9	5.149	0.001	30.5±8.3	19.1±2.7	2.521	0.008
Crs-dep（ml/cmH₂O）	14.6±7.3	8.5±2.6	2.524	0.008	13.0±3.7	5.6±1.1	7.698	＜0.001
VTI	3.1±1.0	3.4±1.1	1.597	0.154	2.5±0.7	3.5±0.8	16.940	＜0.001

指标	ARDSexp（8只）				ARDSp（8只）
指标	造模前	造模后	t值	P值	造模前	造模后	t值	P值
氧合指数（mmHg）	401.6±69.9	147.7±8.2	2.555	0.008	437.0±81.0	196.1±68.0	6.775	＜0.001
平均动脉压（mmHg）	127.4±12.6	103.1±20.5	0.049	0.008	110.5±21.8	110.0±9.7	2.527	0.962
心率（次/分）	51.3±9.4	70.0±23.2	1.977	0.089	48.9±6.9	60.1±23.4	2.106	0.039
MPAP（mmHg）	17.9±1.5	30.3±4.0	2.530	0.008	22.1±2.5	31.5±4.0	7.753	＜0.001
PAWP（mmHg）	7.0±1.8	7.9±4.0	0.106	1.000	10.9±0.8	12.8±2.3	2.311	0.054
CO（L/min）	3.2±2.3	2.1±0.4	1.552	0.148	2.7±0.5	2.8±0.6	0.580	0.580
平台压（cmH₂O）	9.9±1.2	13.2±2.3	5.137	0.001	11.4±1.6	17.6±1.8	20.316	＜0.001
Crs（ml/cmH₂O）	53.6±13.0	37.0±16.3	5.638	＜0.001	43.6±10.0	24.6±2.9	2.527	0.008
Crs-nondep（ml/cmH₂O）	39.0±11.6	28.5±14.9	5.149	0.001	30.5±8.3	19.1±2.7	2.521	0.008
Crs-dep（ml/cmH₂O）	14.6±7.3	8.5±2.6	2.524	0.008	13.0±3.7	5.6±1.1	7.698	＜0.001
VTI	3.1±1.0	3.4±1.1	1.597	0.154	2.5±0.7	3.5±0.8	16.940	＜0.001

指标	ARDSexp				ARDSp
指标	PEEP 25 cmH₂O	PEEP 5 cmH₂O	t值	P值	PEEP 25 cmH₂O	PEEP 5 cmH₂O	t值	P值
氧合指数（mmHg）	447.5±96.0	214.3±128.6	4.208	0.004	173.6±112.0	178.4±128.2	0.074	0.943
平均动脉压（mmHg）	79.1±15.3	106.5±21.4	3.253	0.014	82.5±18.9	85.9±24.1	1.120	0.313
心率（次/分）	114.9±36.6	53.4±15.2	4.599	0.002	96.8±27.9	70.5±22.9	3.468	0.010
MPAP（mmHg）	32.6±5.1	31.2±6.9	0.622	0.554	41.5±4.6	34.8±7.3	3.000	0.020
PAWP（mmHg）	15.3±3.3	11.3±3.5	4.513	0.003	15.4±2.5	12.8±2.1	2.900	0.023
CO（L/min）	1.7±0.6	2.1±0.4	1.410	0.201	2.2±0.9	2.5±0.6	1.037	0.334
平台压（cmH₂O）	34.8±4.4	16.5±7.1	13.110	＜0.001	43.0±4.1	17.5±2.4	18.152	＜0.001
Crs（ml/cmH₂O）	34.4±10.5	35.1±10.9	0.506	0.628	19.4±4.5	30.6±4.9	5.846	＜0.001
Crs-nondep（ml/cmH₂O）	21.7±8.6	26.9±9.8	4.843	0.002	12.3±3.4	24.9±4.2	8.942	＜0.001
Crs-dep（ml/cmH₂O）	12.7±6.3	8.3±4.4	4.272	0.004	7.2±2.6	5.3±2.0	2.553	0.038
VTI	2.0±0.9	3.9±1.4	6.074	＜0.001	1.9±0.7	5.2±2.1	5.163	0.001

指标	ARDSexp				ARDSp
指标	PEEP 25 cmH₂O	PEEP 5 cmH₂O	t值	P值	PEEP 25 cmH₂O	PEEP 5 cmH₂O	t值	P值
氧合指数（mmHg）	447.5±96.0	214.3±128.6	4.208	0.004	173.6±112.0	178.4±128.2	0.074	0.943
平均动脉压（mmHg）	79.1±15.3	106.5±21.4	3.253	0.014	82.5±18.9	85.9±24.1	1.120	0.313
心率（次/分）	114.9±36.6	53.4±15.2	4.599	0.002	96.8±27.9	70.5±22.9	3.468	0.010
MPAP（mmHg）	32.6±5.1	31.2±6.9	0.622	0.554	41.5±4.6	34.8±7.3	3.000	0.020
PAWP（mmHg）	15.3±3.3	11.3±3.5	4.513	0.003	15.4±2.5	12.8±2.1	2.900	0.023
CO（L/min）	1.7±0.6	2.1±0.4	1.410	0.201	2.2±0.9	2.5±0.6	1.037	0.334
平台压（cmH₂O）	34.8±4.4	16.5±7.1	13.110	＜0.001	43.0±4.1	17.5±2.4	18.152	＜0.001
Crs（ml/cmH₂O）	34.4±10.5	35.1±10.9	0.506	0.628	19.4±4.5	30.6±4.9	5.846	＜0.001
Crs-nondep（ml/cmH₂O）	21.7±8.6	26.9±9.8	4.843	0.002	12.3±3.4	24.9±4.2	8.942	＜0.001
Crs-dep（ml/cmH₂O）	12.7±6.3	8.3±4.4	4.272	0.004	7.2±2.6	5.3±2.0	2.553	0.038
VTI	2.0±0.9	3.9±1.4	6.074	＜0.001	1.9±0.7	5.2±2.1	5.163	0.001

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