Radiological Analysis of Lung Injury Progression in Large Animal Model

Students

College

Faculty

Assistant Professor of Anesthesiology and Critical Care

Project Summary

Acute Respiratory Distress Syndrome (ARDS) is a disease associated with inflammation and increased permeability of the alveolar walls, resulting in hypoxemic conditions. Usually induced by the high pressure or volumes of the ventilator, ARDS creates many problems in ICU patients, including pulmonary capillary hypertension and overdistension. After the initial injury, patients are sent into the ICU, where they are put on a ventilator. The ventilator settings may propagate the primary insult and lead to ARDS. Although the large tidal volumes or high PEEP is necessary for the proper aeration of the patient, it can worsen the condition of the lung itself. There are no established biomarkers for ARDS, so its diagnosis is reliant on the ratio of arterial oxygen pressure and percent oxygen of the ventilator. However, ventilating in the prone position, instead of the supine position, does present some benefits. Our quantitative analysis of lung computed tomography (CT) shows some trends which help in the homogeneity of lung injury and overall better aeration. Through CT images, the homogeneity of the injury is clearly seen in the prone position whereas the supine position tends to damage the dorsal regions. Furthermore, using a lower PEEP prevents injury related to atelectasis. However, a lower PEEP prevents the recruitment, or the re-opening of alveoli, lowering the perfusion-ventilation ratio. Using the right scans and mapping the disease is pivotal in the management of ARDS, as it indicates whether to use a more aggressive or conservative ventilator approach.