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Monitoring lung injury with particle flow rate in LPS- and COVID-19-induced ARDS

Stenlo, Martin LU ; Augusto Silva, Iran LU orcid ; Hyllén, Snejana LU ; Bölükbas, Deniz LU ; Niroomand, Anna LU ; Grins, Edgars LU orcid ; Ederoth, Per LU ; Hallgren, Oskar LU ; Pierre, Leif LU and Wagner, Darcy LU orcid , et al. (2021) In Physiological Reports 9(13).
Abstract
In severe acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) is a life-prolonging treatment, especially among COVID-19 patients. Evaluation of lung injury progression is challenging with current techniques. Diagnostic imaging or invasive diagnostics are risky given the difficulties of intra-hospital transportation, contraindication of biopsies, and the potential for the spread of infections, such as in COVID-19 patients. We have recently shown that particle flow rate (PFR) from exhaled breath could be a noninvasive, early detection method for ARDS during mechanical ventilation. We hypothesized that PFR could also measure the progress of lung injury during ECMO treatment. Lipopolysaccharide (LPS) was thus... (More)
In severe acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) is a life-prolonging treatment, especially among COVID-19 patients. Evaluation of lung injury progression is challenging with current techniques. Diagnostic imaging or invasive diagnostics are risky given the difficulties of intra-hospital transportation, contraindication of biopsies, and the potential for the spread of infections, such as in COVID-19 patients. We have recently shown that particle flow rate (PFR) from exhaled breath could be a noninvasive, early detection method for ARDS during mechanical ventilation. We hypothesized that PFR could also measure the progress of lung injury during ECMO treatment. Lipopolysaccharide (LPS) was thus used to induce ARDS in pigs under mechanical ventilation. Eight were connected to ECMO, whereas seven animals were not. In addition, six animals received sham treatment with saline. Four human patients with ECMO and ARDS were also monitored. In the pigs, as lung injury ensued, the PFR dramatically increased and a particular spike followed the establishment of ECMO in the LPS-treated animals. PFR remained elevated in all animals with no signs of lung recovery. In the human patients, in the two that recovered, PFR decreased. In the two whose lung function deteriorated while on ECMO, there was increased PFR with no sign of recovery in lung function. The present results indicate that real-time monitoring of PFR may be a new, complementary approach in the clinic for measurement of the extent of lung injury and recovery over time in ECMO patients with ARDS. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Physiological Reports
volume
9
issue
13
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:34250766
  • scopus:85109946845
ISSN
2051-817X
DOI
10.14814/phy2.14802
language
English
LU publication?
yes
id
ac6ea9f2-0b8b-4f0c-ac40-3434125c34a2
date added to LUP
2021-07-13 14:35:09
date last changed
2023-02-27 08:44:03
@article{ac6ea9f2-0b8b-4f0c-ac40-3434125c34a2,
  abstract     = {{In severe acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) is a life-prolonging treatment, especially among COVID-19 patients. Evaluation of lung injury progression is challenging with current techniques. Diagnostic imaging or invasive diagnostics are risky given the difficulties of intra-hospital transportation, contraindication of biopsies, and the potential for the spread of infections, such as in COVID-19 patients. We have recently shown that particle flow rate (PFR) from exhaled breath could be a noninvasive, early detection method for ARDS during mechanical ventilation. We hypothesized that PFR could also measure the progress of lung injury during ECMO treatment. Lipopolysaccharide (LPS) was thus used to induce ARDS in pigs under mechanical ventilation. Eight were connected to ECMO, whereas seven animals were not. In addition, six animals received sham treatment with saline. Four human patients with ECMO and ARDS were also monitored. In the pigs, as lung injury ensued, the PFR dramatically increased and a particular spike followed the establishment of ECMO in the LPS-treated animals. PFR remained elevated in all animals with no signs of lung recovery. In the human patients, in the two that recovered, PFR decreased. In the two whose lung function deteriorated while on ECMO, there was increased PFR with no sign of recovery in lung function. The present results indicate that real-time monitoring of PFR may be a new, complementary approach in the clinic for measurement of the extent of lung injury and recovery over time in ECMO patients with ARDS.}},
  author       = {{Stenlo, Martin and Augusto Silva, Iran and Hyllén, Snejana and Bölükbas, Deniz and Niroomand, Anna and Grins, Edgars and Ederoth, Per and Hallgren, Oskar and Pierre, Leif and Wagner, Darcy and Lindstedt, Sandra}},
  issn         = {{2051-817X}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{13}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Physiological Reports}},
  title        = {{Monitoring lung injury with particle flow rate in LPS- and COVID-19-induced ARDS}},
  url          = {{http://dx.doi.org/10.14814/phy2.14802}},
  doi          = {{10.14814/phy2.14802}},
  volume       = {{9}},
  year         = {{2021}},
}