Picture of two heads

Open Access research that challenges the mind...

The Strathprints institutional repository is a digital archive of University of Strathclyde research outputs. Strathprints provides access to thousands of Open Access research papers by University of Strathclyde researchers, including those from the School of Psychological Sciences & Health - but also papers by researchers based within the Faculties of Science, Engineering, Humanities & Social Sciences, and from the Strathclyde Business School.

Discover more...

Differences in regional pulmonary pressure-impedance curves before and after lung injury assessed with a novel algorithm

Grychtol, Bartłomiej and Wolf, Gerhard K. and Arnold, John H. (2009) Differences in regional pulmonary pressure-impedance curves before and after lung injury assessed with a novel algorithm. Physiological Measurement, 30 (6). S137-S148. ISSN 0967-3334

Full text not available in this repository. (Request a copy from the Strathclyde author)

Abstract

Global pressure-volume (PV) curves are an adjunct measure to describe lung characteristics in patients with acute respiratory distress syndrome (ARDS). There is convincing evidence that high peak inspiratory pressures (PIP) cause barotrauma, while optimized positive end-expiratory pressure (PEEP) helps avoid mechanical injury to the lungs by preventing repeated alveolar opening and closing. The optimal values of PIP and PEEP are deduced from the shape of the PV curve by the identification of so-called lower and upper inflection points. However, it has been demonstrated using electrical impedance tomography (EIT) that the inflection points vary across the lung. This study employs a simple curve-fitting technique to automatically define inflection points on both pressure-volume (PV) and pressure-impedance (PI) curves to asses the differences between global PV and regional PI estimates in animals before and after induced lung injury. The results demonstrate a clear increase in lower inflection point (LIP) along the gravitational axis both before and after lung injury. Moreover, it is clear from comparison of the local EIT-derived LIPs with those derived from global PV curves that a ventilation strategy based on the PV curve alone may leave dependent areas of the lung collapsed. EIT-based PI curve analysis may help choosing an optimal ventilation strategy.