Effect of fluid and driving pressure on cyclical “on–off” flow of pulmonary microcirculation during mechanical ventilation
Abstract Objectives This study aimed to identify the cyclical “on–off” flow of pulmonary microcirculation during inspiration and expiration by sidestream dark field imaging (SDF) technology in vivo and investigate the effects of volume status and driving pressure on cyclical “on–off” flow of microci...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2024-12-01
|
| Series: | Intensive Care Medicine Experimental |
| Online Access: | https://doi.org/10.1186/s40635-024-00689-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846137517129072640 |
|---|---|
| author | Siyi Yuan Xiangyu Chen Liangyu Mi Yi Chi Haoping Huang Bo Liu Chaofu Yue Zeming Zhao Longxiang Su Yun Long Şakir Akin Can Ince Huaiwu He |
| author_facet | Siyi Yuan Xiangyu Chen Liangyu Mi Yi Chi Haoping Huang Bo Liu Chaofu Yue Zeming Zhao Longxiang Su Yun Long Şakir Akin Can Ince Huaiwu He |
| author_sort | Siyi Yuan |
| collection | DOAJ |
| description | Abstract Objectives This study aimed to identify the cyclical “on–off” flow of pulmonary microcirculation during inspiration and expiration by sidestream dark field imaging (SDF) technology in vivo and investigate the effects of volume status and driving pressure on cyclical “on–off” flow of microcirculation. Methods 24 ARDS-modeled rabbits were randomly divided into high-driving pressure group (HDP group) and low-driving pressure group (LDP group). Lung microcirculation measurements were performed using the SDF microscope at two timepoints (T1 CVP 2–4 mmHg, T2 CVP 8–10 mmHg). From T1 to T2, 10 ml/kg saline was infused to increase CVP. The cyclical “on–off” pulmonary microcirculation was quantitatively assessed by the change of microcirculation between expiration and inspiration. Results Proportion of perfused vessels (PPV), microvascular flow index (MFI), perfused vessel density (PVD), and total vessel density (TVD) at expiration were significantly higher than inspiration in the HDP group. The HDP group has a higher ΔPPV and ΔPVD. After fluid loading, ΔPPV and ΔMFI decreased. TNF-α, IL-6, Ang-2, and vWF levels in the HDP group were higher. The HDP group also has a higher lung wet-weight/body weight ratio, lung wet-to-dry weight ratio, and more severe damage of pulmonary capillaries than the LDP group. Conclusions The difference in alveolar perfused microcirculation between inspiration and expiration defined as cyclical “on–off flow” can be detected. High driving pressure can enhance the cyclical “on–off” flow, and fluid loading can relieve it. High driving pressure can potentially cause injury to pulmonary capillaries due to the phenomenon of “on–off” flow, thereby exacerbating ARDS. |
| format | Article |
| id | doaj-art-83a11f18cea643bbaf92d29dd913ce4a |
| institution | Kabale University |
| issn | 2197-425X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Intensive Care Medicine Experimental |
| spelling | doaj-art-83a11f18cea643bbaf92d29dd913ce4a2024-12-08T12:06:57ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2024-12-0112111010.1186/s40635-024-00689-6Effect of fluid and driving pressure on cyclical “on–off” flow of pulmonary microcirculation during mechanical ventilationSiyi Yuan0Xiangyu Chen1Liangyu Mi2Yi Chi3Haoping Huang4Bo Liu5Chaofu Yue6Zeming Zhao7Longxiang Su8Yun Long9Şakir Akin10Can Ince11Huaiwu He12Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Critical Care Medicine, Affiliated Hospital of Jining Medical UniversityDeparment of Intensive Care Unit, Qu Jing NO.1 HospitalJiamusi Central HospitalDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceDepartment of Intensive Care, Erasmus MC University HospitalDepartment of Intensive Care, Erasmus MC University HospitalDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Dongcheng District, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceAbstract Objectives This study aimed to identify the cyclical “on–off” flow of pulmonary microcirculation during inspiration and expiration by sidestream dark field imaging (SDF) technology in vivo and investigate the effects of volume status and driving pressure on cyclical “on–off” flow of microcirculation. Methods 24 ARDS-modeled rabbits were randomly divided into high-driving pressure group (HDP group) and low-driving pressure group (LDP group). Lung microcirculation measurements were performed using the SDF microscope at two timepoints (T1 CVP 2–4 mmHg, T2 CVP 8–10 mmHg). From T1 to T2, 10 ml/kg saline was infused to increase CVP. The cyclical “on–off” pulmonary microcirculation was quantitatively assessed by the change of microcirculation between expiration and inspiration. Results Proportion of perfused vessels (PPV), microvascular flow index (MFI), perfused vessel density (PVD), and total vessel density (TVD) at expiration were significantly higher than inspiration in the HDP group. The HDP group has a higher ΔPPV and ΔPVD. After fluid loading, ΔPPV and ΔMFI decreased. TNF-α, IL-6, Ang-2, and vWF levels in the HDP group were higher. The HDP group also has a higher lung wet-weight/body weight ratio, lung wet-to-dry weight ratio, and more severe damage of pulmonary capillaries than the LDP group. Conclusions The difference in alveolar perfused microcirculation between inspiration and expiration defined as cyclical “on–off flow” can be detected. High driving pressure can enhance the cyclical “on–off” flow, and fluid loading can relieve it. High driving pressure can potentially cause injury to pulmonary capillaries due to the phenomenon of “on–off” flow, thereby exacerbating ARDS.https://doi.org/10.1186/s40635-024-00689-6 |
| spellingShingle | Siyi Yuan Xiangyu Chen Liangyu Mi Yi Chi Haoping Huang Bo Liu Chaofu Yue Zeming Zhao Longxiang Su Yun Long Şakir Akin Can Ince Huaiwu He Effect of fluid and driving pressure on cyclical “on–off” flow of pulmonary microcirculation during mechanical ventilation Intensive Care Medicine Experimental |
| title | Effect of fluid and driving pressure on cyclical “on–off” flow of pulmonary microcirculation during mechanical ventilation |
| title_full | Effect of fluid and driving pressure on cyclical “on–off” flow of pulmonary microcirculation during mechanical ventilation |
| title_fullStr | Effect of fluid and driving pressure on cyclical “on–off” flow of pulmonary microcirculation during mechanical ventilation |
| title_full_unstemmed | Effect of fluid and driving pressure on cyclical “on–off” flow of pulmonary microcirculation during mechanical ventilation |
| title_short | Effect of fluid and driving pressure on cyclical “on–off” flow of pulmonary microcirculation during mechanical ventilation |
| title_sort | effect of fluid and driving pressure on cyclical on off flow of pulmonary microcirculation during mechanical ventilation |
| url | https://doi.org/10.1186/s40635-024-00689-6 |
| work_keys_str_mv | AT siyiyuan effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT xiangyuchen effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT liangyumi effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT yichi effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT haopinghuang effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT boliu effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT chaofuyue effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT zemingzhao effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT longxiangsu effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT yunlong effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT sakirakin effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT canince effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation AT huaiwuhe effectoffluidanddrivingpressureoncyclicalonoffflowofpulmonarymicrocirculationduringmechanicalventilation |