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Pulmonary colapsed and hyperdistension during prone position and supine position evaluation by electrical impedance tomography and multislice CT scan

Grant number: 07/06677-1
Support Opportunities:Scholarships in Brazil - Doctorate (Direct)
Effective date (Start): December 01, 2007
Effective date (End): November 30, 2011
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Marcelo Britto Passos Amato
Grantee:Marcelo do Amaral Beraldo
Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Associated research grant:01/05303-4 - New strategies in artificial ventilation: diagnosis and prevention of barotrauma/biotrauma through electrical impedance tomography (EIT), AP.TEM

Abstract

Prone positioning improves gas exchange in patients with ARDS. However, the physiological mechanisms responsible for this improvement are still unknown. Objective: To quantify the amount of collapsed and hyperinflated lung tissue at comparable PEEP levels in supine versus prone position. Besides determining critical closing-pressures at each postural condition by EIT and MSCT scan. Methods: Twenty anesthetized Landrace pig model of surfactant depletion follows injurious ventilation for 120 minutes will be then allocated in supine (n=10) and in prone position(n=10). After lung injury, recruitment maneuver will be started with incremental PEEP steps of 2 cmH2O during 2 min from 25 cmH2O to 45 cmH2O with a constant driving pressure of 15 cmH2O. After the maximum recruitment, defined by arterial PO2 > 400 mmHg or after 45 cmH2O of PEEP, we will titrated PEEP downwards (from 25 cmH2O to 5 cmH2O) in steps of 2 cmH2O during 4 min. At the end of each PEEP step we will acquire blood gases samples and the amount of alveolar collapsed by EIT and Multislice CT scan. (AU)

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Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
BERALDO, Marcelo do Amaral. Effects of prone position on regional distribution of lung aeration and perfusion. Analysis by electrical impedance tomography and computer tomography. 2011. Doctoral Thesis - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.

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