The link between regional tidal stretch and lung injury during mechanical ventilation
Methods: Two groups of BALB/c mice (n = 8 per group) were ventilated for 2 h using a protective or injurious ventilation strategy, with free-breathing mice as controls. Regional VT and FRC of the ventilated mice was determined from analysis of high-resolution four-dimensional computed tomography (4D-CT) images, taken at baseline and after 2 h of ventilation and corrected for the volume of the region (i.e. specific [s]Vt and specific [s]FRC). RNA levels of 21 genes in ten different lung regions were quantified using qPCR array.
Results: sFRC at baseline varied regionally, independent of ventilation strategy, whereas sVT varied regionally depending on ventilation strategy. The expression of IL-6 (P = 0.04), Ccl2 (P < 0.01) and Ang 2 (P < 0.05) were associated with sVT but not sFRC. The expression of seven other genes varied regionally (IL-1β and RAGE) or depended on ventilation strategy (Nfe2l2, c-fos and Wnt1) or both (TNF-α and CxCl2), but were not associated with regional sFRC or sVT.
Conclusion: These observations suggest that regional inflammatory responses to mechanical ventilation are primarily driven by tidal stretch.
Publication titleAmerican Journal of Respiratory Cell and Molecular Biology
Department/SchoolTasmanian School of Medicine
PublisherAmerican Thoracic Society
Place of publicationUnited States
Rights statementCopyright © 2019 American Thoracic Society. Originally Published in: Yen, S and Preissner, M and Bennett, E and Dubsky, S and Carnibella, R and O'Toole, R and Roddam, L and Jones, H and Dargaville, PA and Fouras, A and Zosky, GR, The link between regional tidal stretch and lung injury during mechanical ventilation, American Journal of Respiratory Cell and Molecular Biology pp. 1-35. ISSN 1535-4989 (2018). The final publication is available at: