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Author: search.filters.author.Benjamín ErranzSubject: search.filters.subject.mechanical ventilation

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    Scopus© Citations 11  1
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    Progression of regional lung strain and heterogeneity in lung injury: assessing the evolution under spontaneous breathing and mechanical ventilation
    (2020)
    Daniel E. Hurtado
    ;
    Benjamín Erranz
    ;
    Felipe Lillo
    ;
    Mauricio Sarabia-Vallejos
    ;
    Pablo Iturrieta
    <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Protective mechanical ventilation (MV) aims at limiting global lung deformation and has been associated with better clinical outcomes in acute respiratory distress syndrome (ARDS) patients. In ARDS lungs without MV support, the mechanisms and evolution of lung tissue deformation remain understudied. In this work, we quantify the progression and heterogeneity of regional strain in injured lungs under spontaneous breathing and under MV.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Lung injury was induced by lung lavage in murine subjects, followed by 3 h of spontaneous breathing (SB-group) or 3 h of low <jats:italic>V</jats:italic><jats:sub>t</jats:sub> mechanical ventilation (MV-group). Micro-CT images were acquired in all subjects at the beginning and at the end of the ventilation stage following induction of lung injury. Regional strain, strain progression and strain heterogeneity were computed from image-based biomechanical analysis. Three-dimensional regional strain maps were constructed, from which a region-of-interest (ROI) analysis was performed for the regional strain, the strain progression, and the strain heterogeneity.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>After 3 h of ventilation, regional strain levels were significantly higher in 43.7% of the ROIs in the SB-group. Significant increase in regional strain was found in 1.2% of the ROIs in the MV-group. Progression of regional strain was found in 100% of the ROIs in the SB-group, whereas the MV-group displayed strain progression in 1.2% of the ROIs. Progression in regional strain heterogeneity was found in 23.4% of the ROIs in the SB-group, while the MV-group resulted in 4.7% of the ROIs showing significant changes. Deformation progression is concurrent with an increase of non-aerated compartment in SB-group (from 13.3% ± 1.6% to 37.5% ± 3.1%), being higher in ventral regions of the lung.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Spontaneous breathing in lung injury promotes regional strain and strain heterogeneity progression. In contrast, low <jats:italic>V</jats:italic><jats:sub>t</jats:sub> MV prevents regional strain and heterogeneity progression in injured lungs.</jats:p> </jats:sec>
    Scopus© Citations 43  1
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    A physiological approach to understand the role of respiratory effort in the progression of lung injury in SARS-CoV-2 infection
    (2020)
    Pablo Cruces
    ;
    Jaime Retamal
    ;
    Daniel E. Hurtado
    ;
    Benjamín Erranz
    ;
    Pablo Iturrieta
    <jats:title>Abstract</jats:title><jats:p>Deterioration of lung function during the first week of COVID-19 has been observed when patients remain with insufficient respiratory support. Patient self-inflicted lung injury (P-SILI) is theorized as the responsible, but there is not robust experimental and clinical data to support it. Given the limited understanding of P-SILI, we describe the physiological basis of P-SILI and we show experimental data to comprehend the role of regional strain and heterogeneity in lung injury due to increased work of breathing.</jats:p><jats:p>In addition, we discuss the current approach to respiratory support for COVID-19 under this point of view.</jats:p>
      8Scopus© Citations 103
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    Positive end-expiratory pressure improves elastic working pressure in anesthetized children
    (2018)
    Pablo Cruces
    ;
    Sebastián González-Dambrauskas
    ;
    Federico Cristiani
    ;
    Javier Martínez
    ;
    Ronnie Henderson
    Scopus© Citations 6  1
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      6Scopus© Citations 36
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    Near-Apneic Ventilation Decreases Lung Injury and Fibroproliferation in an ARDS Model with ECMO
    (2019)
    Joaquin Araos
    ;
    Leyla Alegria
    ;
    Patricio Garcia
    ;
    Pablo Cruces
    ;
    Dagoberto Soto
      13Scopus© Citations 96
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    Scopus© Citations 1  1