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Surfactant deactivation in a pediatric model induces hypovolemia and fluid shift to the extravascular lung compartment
(2012)
FRANCO JAVIER DIAZ RUBIO
;
Benjamín Erranz
;
Alejandro Donoso
;
CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL
;
Tatiana Salomón
Surfactant deficiency is the pivotal abnormality in Neonatal and Acute Respiratory Distress Syndrome. Surfactant deactivation can produce hypoxemia, loss of lung compliance, and pulmonary edema, but its circulatory consequences are less understood. Objective To describe the sequential hemodynamic changes and pulmonary edema formation after surfactant deactivation in piglets. Methods: Surfactant deactivation was induced by tracheal instillation of polysorbate 20 in 15 anesthetized and mechanically ventilated Large White piglets. The hemodynamic consequences of surfactant deactivation were assessed at 30, 120, and 240 min by transpulmonary thermodilution and traditional methods. Results: Surfactant deactivation caused hypoxemia, reduced lung compliance, and progressively increased lung water content (P < 0.01). Early hypovolemia was observed, with reductions of the global end-diastolic volume and stroke volume (P < 0.05). Reduced cardiac output was observed at the end of the study (P < 0.05). Standard monitoring was unable to detect these early preload alterations. Surprisingly, the bronchoalveolar protein content was greatly increased at the end of the study compared with baseline levels (P < 0.01). This finding was inconsistent with the notion that the pulmonary edema induced by surfactant deactivation was exclusively caused by high surface tension. Conclusions: Hypovolemia develops early after surfactant deactivation, in part due to the resulting fluid shift from the intravascular compartment to the lungs
Scopus© Citations 5 4
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Mild hypothermia attenuates lung edema and plasma interleukin-1β in a rat mechanical ventilation-induced lung injury model
(2011)
Cruces, Pablo
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Ronco, Ricardo
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Benjamín Erranz
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CONGET MOLINA, PAULETTE ANDREA
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CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL
33Scopus© Citations 9
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Angiotensin-converting enzyme insertion/deletion polymorphism is associated with severe hypoxemia in pediatric ARDS
(2011)
Pablo Cruces
;
Franco Díaz
;
Alonso Puga
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Benjamín Erranz
;
Alejandro Donoso
Scopus© Citations 26 1
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Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental
(2012)
Franco Díaz
;
Alejandro Donoso
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CARVAJAL BENAVIDES, CÉSAR CRISTÓBAL
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Tatiana Salomón
;
María Torres
14
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Effect of positive end-expiratory pressure on lung injury and haemodynamics during experimental acute respiratory distress syndrome treated with extracorporeal membrane oxygenation and near-apnoeic ventilation
(2021)
Joaquin Araos
;
Leyla Alegria
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Aline Garcia
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Pablo Cruces
;
Dagoberto Soto
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
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Benjamín Erranz
;
Felipe Lillo
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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
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Daniel E. Hurtado
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Benjamín Erranz
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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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Incorporación de estándares bioéticos para la generación de conocimiento científico de calidad en investigación en fauna silvestre: Ciencia con conciencia
(2020)
Tamara A. Tadich
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Inés De Freslón
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Carmen Gallo
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Jesús M. Zúñiga
;
Ronald Vargas
5Scopus© Citations 3
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Genetic predisposition and pediatric acute respiratory distress syndrome: New tools for genetic study [Predisposición genética y síndrome de distrés respiratorio agudo pediátrico: Nuevas herramientas de estudio genético]
(2015)
Benjamín Erranz
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B. Jan Wilhelm
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V. Raquel Riquelme
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R. Pablo Cruces
1
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Influence of tidal volume on pulse pressure variation and stroke volume variation during experimental intra-abdominal hypertension
(2015)
F. Díaz
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Benjamín Erranz
;
A. Donoso
;
T. Salomon
;
Pablo Cruces
13Scopus© Citations 38

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