Near-real-time pulmonary shunt and dead space measurement with micropore membrane inlet mass spectrometry in pigs with induced pulmonary embolism or acute lung failure.

The multiple inert gas elimination technique (MIGET) using gas chromatography (GC) is an established but time-consuming method of determining ventilation/perfusion (VA/Q) distributions. MIGET-when performed using Micropore Membrane Inlet Mass Spectrometry (MMIMS)-has been proven to correlate well wi...

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Publicado en:Journal of Clinical Monitoring & Computing Vol. 33; no. 6; pp. 1033 - 1042
Autores principales: Gerber, D., Vasireddy, R., Varadarajan, B., Hartwich, V., Schär, M. Y., Eberle, B., Vogt, A.
Formato: Journal Article
Publicado: Springer Nature Dec2019
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Near-real-time pulmonary shunt and dead space measurement with micropore membrane inlet mass spectrometry in pigs with induced pulmonary embolism or acute lung failure.
      aug:
        au:
          Gerber, D.
          Vasireddy, R.
          Varadarajan, B.
          Hartwich, V.
          Schär, M. Y.
          Eberle, B.
          Vogt, A.
        affil: Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland
      sug:
        subj:
          Lung
          Respiratory Dead Space
          Pulmonary Embolism Physiopathology
          Lung Injury Physiopathology
          Pulmonary Embolism Surgery
          Anesthesia, General
          Filtration
          Mass Spectrometry
          Lung Injury Surgery
          Animals
          Ventilation-Perfusion Ratio
          Propofol Administration and Dosage
          Chromatography, Gas
          Swine
          Gases
          Blood Gas Analysis
          Hemodynamics
          Scales
      ab: The multiple inert gas elimination technique (MIGET) using gas chromatography (GC) is an established but time-consuming method of determining ventilation/perfusion (VA/Q) distributions. MIGET-when performed using Micropore Membrane Inlet Mass Spectrometry (MMIMS)-has been proven to correlate well with GC-MIGET and reduces analysis time substantially. We aimed at comparing shunt fractions and dead space derived from MMIMS-MIGET with Riley shunt and Bohr dead space, respectively. Thirty anesthetized pigs were randomly assigned to lavage or pulmonary embolism groups. Inert gas infusion (saline mixture of SF6, krypton, desflurane, enflurane, diethyl ether, acetone) was maintained, and after induction of lung damage, blood and breath samples were taken at 15-min intervals over 4 h. The samples were injected into the MMIMS, and resultant retention and excretion data were translated to VA/Q distributions. We compared MMIMS-derived shunt (MM-S) to Riley shunt, and MMIMS-derived dead space (MM-VD) to Bohr dead space in 349 data pairs. MM-S was on average lower than Riley shunt (- 0.05 ± 0.10), with lower and upper limits of agreement of - 0.15 and 0.04, respectively. MM-VD was on average lower than Bohr dead space (- 0.09 ± 0.14), with lower and upper limits of agreement of - 0.24 and 0.05. MM-S and MM-VD correlated and agreed well with Riley shunt and with Bohr dead space. MM-S increased significantly after lung injury only in the lavage group, whereas MM-VD increased significantly in both groups. This is the first work evaluating and demonstrating the feasibility of near real-time VA/Q distribution measurements with the MIGET and the MMIMS methods.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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