Unstable Inflation Causing Injury. Insight from Prone Position and Paired Computed Tomography Scans
It remains unclear how prone positioning improves survival in acute respiratory distress syndrome. Using serial computed tomography (CT), we previously reported that "unstable" inflation (i.e., partial aeration with large tidal density swings, indicating increased local strain) is associat...
Gespeichert in:
| Veröffentlicht in: | American journal of respiratory and critical care medicine 2018-07, Vol.198 (2), p.197-207 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 207 |
|---|---|
| container_issue | 2 |
| container_start_page | 197 |
| container_title | American journal of respiratory and critical care medicine |
| container_volume | 198 |
| creator | Xin, Yi Cereda, Maurizio Hamedani, Hooman Pourfathi, Mehrdad Siddiqui, Sarmad Meeder, Natalie Kadlecek, Stephen Duncan, Ian Profka, Harrilla Rajaei, Jennia Tustison, Nicholas J Gee, James C Kavanagh, Brian P Rizi, Rahim R |
| description | It remains unclear how prone positioning improves survival in acute respiratory distress syndrome. Using serial computed tomography (CT), we previously reported that "unstable" inflation (i.e., partial aeration with large tidal density swings, indicating increased local strain) is associated with injury progression.
We prospectively tested whether prone position contains the early propagation of experimental lung injury by stabilizing inflation.
Injury was induced by tracheal hydrochloric acid in rats; after randomization to supine or prone position, injurious ventilation was commenced using high tidal volume and low positive end-expiratory pressure. Paired end-inspiratory (EI) and end-expiratory (EE) CT scans were acquired at baseline and hourly up to 3 hours. Each sequential pair (EI, EE) of CT images was superimposed in parametric response maps to analyze inflation. Unstable inflation was then measured in each voxel in both dependent and nondependent lung. In addition, five pigs were imaged (EI and EE) prone versus supine, before and (1 hour) after hydrochloric acid aspiration.
In rats, prone position limited lung injury propagation and increased survival (11/12 vs. 7/12 supine; P = 0.01). EI-EE densities, respiratory mechanics, and blood gases deteriorated more in supine versus prone rats. At baseline, more voxels with unstable inflation occurred in dependent versus nondependent regions when supine (41 ± 6% vs. 18 ± 7%; P |
| doi_str_mv | 10.1164/rccm.201708-1728OC |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6058981</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2077530925</sourcerecordid><originalsourceid>FETCH-LOGICAL-c430t-3601b12705bb1c522fc32dedb86b9bf8470bcaf544b19f87c509d67f740583f53</originalsourceid><addsrcrecordid>eNpdkU1r3DAQhkVpaNK0f6CHYuglF29GH7asS6GYfgQCWWgCvQlJlna12NJWsgv776PtpqHtaYaZd15m5kHoHYYVxi27TsZMKwKYQ1djTrq7_gW6wA1taiY4vCw5cFozJn6co9c57wAw6TC8QudEMAIC2AUyDyHPSo-2ugluVLOPoerVkn3YlMpuSYdVidlvtnPlUpyqdYrBVuuY_W-tCkO1Vj7ZoerjtF_mktzHKW6S2m8P1XejQn6Dzpwas337FC_Rw5fP9_23-vbu603_6bY2jMJc0xawxoRDozU2DSHOUDLYQXetFtp1jIM2yjWMaSxcx00DYmi54wyajrqGXqKPJ9_9oic7GBvmpEa5T35S6SCj8vLfTvBbuYm_ZFsMRIeLwdWTQYo_F5tnOfls7DiqYOOSJSkfhJYLBkX64T_pLi4plPOKivOGgiDHjchJZVLMOVn3vAwGeWQojwzliaE8MSxD7_8-43nkDzT6CNSTmaY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2077530925</pqid></control><display><type>article</type><title>Unstable Inflation Causing Injury. Insight from Prone Position and Paired Computed Tomography Scans</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><source>American Thoracic Society (ATS) Journals Online</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Xin, Yi ; Cereda, Maurizio ; Hamedani, Hooman ; Pourfathi, Mehrdad ; Siddiqui, Sarmad ; Meeder, Natalie ; Kadlecek, Stephen ; Duncan, Ian ; Profka, Harrilla ; Rajaei, Jennia ; Tustison, Nicholas J ; Gee, James C ; Kavanagh, Brian P ; Rizi, Rahim R</creator><creatorcontrib>Xin, Yi ; Cereda, Maurizio ; Hamedani, Hooman ; Pourfathi, Mehrdad ; Siddiqui, Sarmad ; Meeder, Natalie ; Kadlecek, Stephen ; Duncan, Ian ; Profka, Harrilla ; Rajaei, Jennia ; Tustison, Nicholas J ; Gee, James C ; Kavanagh, Brian P ; Rizi, Rahim R</creatorcontrib><description>It remains unclear how prone positioning improves survival in acute respiratory distress syndrome. Using serial computed tomography (CT), we previously reported that "unstable" inflation (i.e., partial aeration with large tidal density swings, indicating increased local strain) is associated with injury progression.
We prospectively tested whether prone position contains the early propagation of experimental lung injury by stabilizing inflation.
Injury was induced by tracheal hydrochloric acid in rats; after randomization to supine or prone position, injurious ventilation was commenced using high tidal volume and low positive end-expiratory pressure. Paired end-inspiratory (EI) and end-expiratory (EE) CT scans were acquired at baseline and hourly up to 3 hours. Each sequential pair (EI, EE) of CT images was superimposed in parametric response maps to analyze inflation. Unstable inflation was then measured in each voxel in both dependent and nondependent lung. In addition, five pigs were imaged (EI and EE) prone versus supine, before and (1 hour) after hydrochloric acid aspiration.
In rats, prone position limited lung injury propagation and increased survival (11/12 vs. 7/12 supine; P = 0.01). EI-EE densities, respiratory mechanics, and blood gases deteriorated more in supine versus prone rats. At baseline, more voxels with unstable inflation occurred in dependent versus nondependent regions when supine (41 ± 6% vs. 18 ± 7%; P < 0.01) but not when prone. In supine pigs, unstable inflation predominated in dorsal regions and was attenuated by prone positioning.
Prone position limits the radiologic progression of early lung injury. Minimizing unstable inflation in this setting may alleviate the burden of acute respiratory distress syndrome.</description><identifier>ISSN: 1073-449X</identifier><identifier>ISSN: 1535-4970</identifier><identifier>EISSN: 1535-4970</identifier><identifier>DOI: 10.1164/rccm.201708-1728OC</identifier><identifier>PMID: 29420904</identifier><language>eng</language><publisher>United States: American Thoracic Society</publisher><subject>Animals ; Clinical trials ; Gene expression ; Humans ; Hydrochloric acid ; Intensive care ; Medical imaging ; Medical prognosis ; Metabolism ; Models, Animal ; Mortality ; Original ; Patient Positioning - methods ; Positive-Pressure Respiration - methods ; Prone Position - physiology ; Propagation ; Rats ; Respiration, Artificial - methods ; Respiratory distress syndrome ; Respiratory Distress Syndrome - complications ; Respiratory Distress Syndrome - therapy ; Respiratory therapy ; Supine Position - physiology ; Swine ; Systematic review ; Tomography, X-Ray Computed - methods ; Ultrasonic imaging ; Ventilator-Induced Lung Injury - etiology ; Ventilator-Induced Lung Injury - prevention & control ; Ventilators</subject><ispartof>American journal of respiratory and critical care medicine, 2018-07, Vol.198 (2), p.197-207</ispartof><rights>Copyright American Thoracic Society Jul 15, 2018</rights><rights>Copyright © 2018 by the American Thoracic Society 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c430t-3601b12705bb1c522fc32dedb86b9bf8470bcaf544b19f87c509d67f740583f53</citedby><cites>FETCH-LOGICAL-c430t-3601b12705bb1c522fc32dedb86b9bf8470bcaf544b19f87c509d67f740583f53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,4022,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29420904$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xin, Yi</creatorcontrib><creatorcontrib>Cereda, Maurizio</creatorcontrib><creatorcontrib>Hamedani, Hooman</creatorcontrib><creatorcontrib>Pourfathi, Mehrdad</creatorcontrib><creatorcontrib>Siddiqui, Sarmad</creatorcontrib><creatorcontrib>Meeder, Natalie</creatorcontrib><creatorcontrib>Kadlecek, Stephen</creatorcontrib><creatorcontrib>Duncan, Ian</creatorcontrib><creatorcontrib>Profka, Harrilla</creatorcontrib><creatorcontrib>Rajaei, Jennia</creatorcontrib><creatorcontrib>Tustison, Nicholas J</creatorcontrib><creatorcontrib>Gee, James C</creatorcontrib><creatorcontrib>Kavanagh, Brian P</creatorcontrib><creatorcontrib>Rizi, Rahim R</creatorcontrib><title>Unstable Inflation Causing Injury. Insight from Prone Position and Paired Computed Tomography Scans</title><title>American journal of respiratory and critical care medicine</title><addtitle>Am J Respir Crit Care Med</addtitle><description>It remains unclear how prone positioning improves survival in acute respiratory distress syndrome. Using serial computed tomography (CT), we previously reported that "unstable" inflation (i.e., partial aeration with large tidal density swings, indicating increased local strain) is associated with injury progression.
We prospectively tested whether prone position contains the early propagation of experimental lung injury by stabilizing inflation.
Injury was induced by tracheal hydrochloric acid in rats; after randomization to supine or prone position, injurious ventilation was commenced using high tidal volume and low positive end-expiratory pressure. Paired end-inspiratory (EI) and end-expiratory (EE) CT scans were acquired at baseline and hourly up to 3 hours. Each sequential pair (EI, EE) of CT images was superimposed in parametric response maps to analyze inflation. Unstable inflation was then measured in each voxel in both dependent and nondependent lung. In addition, five pigs were imaged (EI and EE) prone versus supine, before and (1 hour) after hydrochloric acid aspiration.
In rats, prone position limited lung injury propagation and increased survival (11/12 vs. 7/12 supine; P = 0.01). EI-EE densities, respiratory mechanics, and blood gases deteriorated more in supine versus prone rats. At baseline, more voxels with unstable inflation occurred in dependent versus nondependent regions when supine (41 ± 6% vs. 18 ± 7%; P < 0.01) but not when prone. In supine pigs, unstable inflation predominated in dorsal regions and was attenuated by prone positioning.
Prone position limits the radiologic progression of early lung injury. Minimizing unstable inflation in this setting may alleviate the burden of acute respiratory distress syndrome.</description><subject>Animals</subject><subject>Clinical trials</subject><subject>Gene expression</subject><subject>Humans</subject><subject>Hydrochloric acid</subject><subject>Intensive care</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Metabolism</subject><subject>Models, Animal</subject><subject>Mortality</subject><subject>Original</subject><subject>Patient Positioning - methods</subject><subject>Positive-Pressure Respiration - methods</subject><subject>Prone Position - physiology</subject><subject>Propagation</subject><subject>Rats</subject><subject>Respiration, Artificial - methods</subject><subject>Respiratory distress syndrome</subject><subject>Respiratory Distress Syndrome - complications</subject><subject>Respiratory Distress Syndrome - therapy</subject><subject>Respiratory therapy</subject><subject>Supine Position - physiology</subject><subject>Swine</subject><subject>Systematic review</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Ultrasonic imaging</subject><subject>Ventilator-Induced Lung Injury - etiology</subject><subject>Ventilator-Induced Lung Injury - prevention & control</subject><subject>Ventilators</subject><issn>1073-449X</issn><issn>1535-4970</issn><issn>1535-4970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkU1r3DAQhkVpaNK0f6CHYuglF29GH7asS6GYfgQCWWgCvQlJlna12NJWsgv776PtpqHtaYaZd15m5kHoHYYVxi27TsZMKwKYQ1djTrq7_gW6wA1taiY4vCw5cFozJn6co9c57wAw6TC8QudEMAIC2AUyDyHPSo-2ugluVLOPoerVkn3YlMpuSYdVidlvtnPlUpyqdYrBVuuY_W-tCkO1Vj7ZoerjtF_mktzHKW6S2m8P1XejQn6Dzpwas337FC_Rw5fP9_23-vbu603_6bY2jMJc0xawxoRDozU2DSHOUDLYQXetFtp1jIM2yjWMaSxcx00DYmi54wyajrqGXqKPJ9_9oic7GBvmpEa5T35S6SCj8vLfTvBbuYm_ZFsMRIeLwdWTQYo_F5tnOfls7DiqYOOSJSkfhJYLBkX64T_pLi4plPOKivOGgiDHjchJZVLMOVn3vAwGeWQojwzliaE8MSxD7_8-43nkDzT6CNSTmaY</recordid><startdate>20180715</startdate><enddate>20180715</enddate><creator>Xin, Yi</creator><creator>Cereda, Maurizio</creator><creator>Hamedani, Hooman</creator><creator>Pourfathi, Mehrdad</creator><creator>Siddiqui, Sarmad</creator><creator>Meeder, Natalie</creator><creator>Kadlecek, Stephen</creator><creator>Duncan, Ian</creator><creator>Profka, Harrilla</creator><creator>Rajaei, Jennia</creator><creator>Tustison, Nicholas J</creator><creator>Gee, James C</creator><creator>Kavanagh, Brian P</creator><creator>Rizi, Rahim R</creator><general>American Thoracic Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180715</creationdate><title>Unstable Inflation Causing Injury. Insight from Prone Position and Paired Computed Tomography Scans</title><author>Xin, Yi ; Cereda, Maurizio ; Hamedani, Hooman ; Pourfathi, Mehrdad ; Siddiqui, Sarmad ; Meeder, Natalie ; Kadlecek, Stephen ; Duncan, Ian ; Profka, Harrilla ; Rajaei, Jennia ; Tustison, Nicholas J ; Gee, James C ; Kavanagh, Brian P ; Rizi, Rahim R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c430t-3601b12705bb1c522fc32dedb86b9bf8470bcaf544b19f87c509d67f740583f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Animals</topic><topic>Clinical trials</topic><topic>Gene expression</topic><topic>Humans</topic><topic>Hydrochloric acid</topic><topic>Intensive care</topic><topic>Medical imaging</topic><topic>Medical prognosis</topic><topic>Metabolism</topic><topic>Models, Animal</topic><topic>Mortality</topic><topic>Original</topic><topic>Patient Positioning - methods</topic><topic>Positive-Pressure Respiration - methods</topic><topic>Prone Position - physiology</topic><topic>Propagation</topic><topic>Rats</topic><topic>Respiration, Artificial - methods</topic><topic>Respiratory distress syndrome</topic><topic>Respiratory Distress Syndrome - complications</topic><topic>Respiratory Distress Syndrome - therapy</topic><topic>Respiratory therapy</topic><topic>Supine Position - physiology</topic><topic>Swine</topic><topic>Systematic review</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Ultrasonic imaging</topic><topic>Ventilator-Induced Lung Injury - etiology</topic><topic>Ventilator-Induced Lung Injury - prevention & control</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xin, Yi</creatorcontrib><creatorcontrib>Cereda, Maurizio</creatorcontrib><creatorcontrib>Hamedani, Hooman</creatorcontrib><creatorcontrib>Pourfathi, Mehrdad</creatorcontrib><creatorcontrib>Siddiqui, Sarmad</creatorcontrib><creatorcontrib>Meeder, Natalie</creatorcontrib><creatorcontrib>Kadlecek, Stephen</creatorcontrib><creatorcontrib>Duncan, Ian</creatorcontrib><creatorcontrib>Profka, Harrilla</creatorcontrib><creatorcontrib>Rajaei, Jennia</creatorcontrib><creatorcontrib>Tustison, Nicholas J</creatorcontrib><creatorcontrib>Gee, James C</creatorcontrib><creatorcontrib>Kavanagh, Brian P</creatorcontrib><creatorcontrib>Rizi, Rahim R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of respiratory and critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xin, Yi</au><au>Cereda, Maurizio</au><au>Hamedani, Hooman</au><au>Pourfathi, Mehrdad</au><au>Siddiqui, Sarmad</au><au>Meeder, Natalie</au><au>Kadlecek, Stephen</au><au>Duncan, Ian</au><au>Profka, Harrilla</au><au>Rajaei, Jennia</au><au>Tustison, Nicholas J</au><au>Gee, James C</au><au>Kavanagh, Brian P</au><au>Rizi, Rahim R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unstable Inflation Causing Injury. Insight from Prone Position and Paired Computed Tomography Scans</atitle><jtitle>American journal of respiratory and critical care medicine</jtitle><addtitle>Am J Respir Crit Care Med</addtitle><date>2018-07-15</date><risdate>2018</risdate><volume>198</volume><issue>2</issue><spage>197</spage><epage>207</epage><pages>197-207</pages><issn>1073-449X</issn><issn>1535-4970</issn><eissn>1535-4970</eissn><abstract>It remains unclear how prone positioning improves survival in acute respiratory distress syndrome. Using serial computed tomography (CT), we previously reported that "unstable" inflation (i.e., partial aeration with large tidal density swings, indicating increased local strain) is associated with injury progression.
We prospectively tested whether prone position contains the early propagation of experimental lung injury by stabilizing inflation.
Injury was induced by tracheal hydrochloric acid in rats; after randomization to supine or prone position, injurious ventilation was commenced using high tidal volume and low positive end-expiratory pressure. Paired end-inspiratory (EI) and end-expiratory (EE) CT scans were acquired at baseline and hourly up to 3 hours. Each sequential pair (EI, EE) of CT images was superimposed in parametric response maps to analyze inflation. Unstable inflation was then measured in each voxel in both dependent and nondependent lung. In addition, five pigs were imaged (EI and EE) prone versus supine, before and (1 hour) after hydrochloric acid aspiration.
In rats, prone position limited lung injury propagation and increased survival (11/12 vs. 7/12 supine; P = 0.01). EI-EE densities, respiratory mechanics, and blood gases deteriorated more in supine versus prone rats. At baseline, more voxels with unstable inflation occurred in dependent versus nondependent regions when supine (41 ± 6% vs. 18 ± 7%; P < 0.01) but not when prone. In supine pigs, unstable inflation predominated in dorsal regions and was attenuated by prone positioning.
Prone position limits the radiologic progression of early lung injury. Minimizing unstable inflation in this setting may alleviate the burden of acute respiratory distress syndrome.</abstract><cop>United States</cop><pub>American Thoracic Society</pub><pmid>29420904</pmid><doi>10.1164/rccm.201708-1728OC</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1073-449X |
| ispartof | American journal of respiratory and critical care medicine, 2018-07, Vol.198 (2), p.197-207 |
| issn | 1073-449X 1535-4970 1535-4970 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6058981 |
| source | MEDLINE; Journals@Ovid Complete; American Thoracic Society (ATS) Journals Online; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Animals Clinical trials Gene expression Humans Hydrochloric acid Intensive care Medical imaging Medical prognosis Metabolism Models, Animal Mortality Original Patient Positioning - methods Positive-Pressure Respiration - methods Prone Position - physiology Propagation Rats Respiration, Artificial - methods Respiratory distress syndrome Respiratory Distress Syndrome - complications Respiratory Distress Syndrome - therapy Respiratory therapy Supine Position - physiology Swine Systematic review Tomography, X-Ray Computed - methods Ultrasonic imaging Ventilator-Induced Lung Injury - etiology Ventilator-Induced Lung Injury - prevention & control Ventilators |
| title | Unstable Inflation Causing Injury. Insight from Prone Position and Paired Computed Tomography Scans |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T18%3A51%3A36IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Unstable%20Inflation%20Causing%20Injury.%20Insight%20from%20Prone%20Position%20and%20Paired%20Computed%20Tomography%20Scans&rft.jtitle=American%20journal%20of%20respiratory%20and%20critical%20care%20medicine&rft.au=Xin,%20Yi&rft.date=2018-07-15&rft.volume=198&rft.issue=2&rft.spage=197&rft.epage=207&rft.pages=197-207&rft.issn=1073-449X&rft.eissn=1535-4970&rft_id=info:doi/10.1164/rccm.201708-1728OC&rft_dat=%3Cproquest_pubme%3E2077530925%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2077530925&rft_id=info:pmid/29420904&rfr_iscdi=true |