Low-volume ventilation of preinjured lungs degrades lung function via stress concentration and progressive alveolar collapse

Author:

Zimmermann Richard1,Roeder Franziska1,Ruppert Clemens23ORCID,Smith Bradford J.45ORCID,Knudsen Lars16ORCID

Affiliation:

1. Institute of Functional and Applied Anatomy, Hannover Medical School, Hannover, Germany

2. Department of Internal Medicine, Justus-Liebig-University Giessen, Giessen, Germany

3. University of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL), Giessen, Germany

4. Department of Bioengineering, College of Engineering, Design & Computing, University of Colorado Denver | Anschutz Medical Campus, Aurora, Colorado, United States

5. Section of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, United States

6. Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany

Abstract

Low-volume mechanical ventilation in the presence of high surface tension-induced microatelectases leads to the degradation of lung mechanical function via the progressive loss of alveoli. Microatelectases grow at the interfaces of collapsed and open alveoli. Here, stress concentrations might cause injury and alveolar instability. Accumulation of small amounts of alveolar edema can be found in a fraction of partly collapsed alveoli but, in this model, alveolar flooding is not a major driver for degradation of lung mechanics.

Funder

Deutsche Forschungsgemeinschaft

Deutsches Zentrum für Lungenforschung

Publisher

American Physiological Society

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