Airway Closure and Expiratory Flow Limitation in Acute Respiratory Distress Syndrome.
COVID-19
acute respiratory distress syndrome
airway closure
expiratory flow limitation
positive end-expiratory pressure
respiratory mechanics
Journal
Frontiers in physiology
ISSN: 1664-042X
Titre abrégé: Front Physiol
Pays: Switzerland
ID NLM: 101549006
Informations de publication
Date de publication:
2021
2021
Historique:
received:
15
11
2021
accepted:
09
12
2021
entrez:
3
2
2022
pubmed:
4
2
2022
medline:
4
2
2022
Statut:
epublish
Résumé
Acute respiratory distress syndrome (ARDS) is mostly characterized by the loss of aerated lung volume associated with an increase in lung tissue and intense and complex lung inflammation. ARDS has long been associated with the histological pattern of diffuse alveolar damage (DAD). However, DAD is not the unique pathological figure in ARDS and it can also be observed in settings other than ARDS. In the coronavirus disease 2019 (COVID-19) related ARDS, the impairment of lung microvasculature has been pointed out. The airways, and of notice the small peripheral airways, may contribute to the loss of aeration observed in ARDS. High-resolution lung imaging techniques found that in specific experimental conditions small airway closure was a reality. Furthermore, low-volume ventilator-induced lung injury, also called as atelectrauma, should involve the airways. Atelectrauma is one of the basic tenet subtending the use of positive end-expiratory pressure (PEEP) set at the ventilator in ARDS. Recent data revisited the role of airways in humans with ARDS and provided findings consistent with the expiratory flow limitation and airway closure in a substantial number of patients with ARDS. We discussed the pattern of airway opening pressure disclosed in the inspiratory volume-pressure curves in COVID-19 and in non-COVID-19 related ARDS. In addition, we discussed the functional interplay between airway opening pressure and expiratory flow limitation displayed in the flow-volume curves. We discussed the individualization of the PEEP setting based on these findings.
Identifiants
pubmed: 35111078
doi: 10.3389/fphys.2021.815601
pmc: PMC8801584
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
815601Informations de copyright
Copyright © 2022 Guérin, Cour and Argaud.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Br J Anaesth. 1998 Nov;81(5):681-6
pubmed: 10193276
Am J Respir Crit Care Med. 2001 Jul 1;164(1):122-30
pubmed: 11435250
Am J Respir Crit Care Med. 2020 Jul 15;202(2):287-290
pubmed: 32479162
Intensive Care Med. 2019 Feb;45(2):290-291
pubmed: 30560279
Am J Respir Crit Care Med. 1994 Nov;150(5 Pt 1):1311-7
pubmed: 7952558
J Appl Physiol (1985). 2010 Jan;108(1):212-8
pubmed: 19910329
J Appl Physiol (1985). 2008 Jan;104(1):41-9
pubmed: 17962576
Acta Anaesthesiol Scand. 1980 Aug;24(4):299-304
pubmed: 7468117
Am J Med. 1972 Jun;52(6):747-53
pubmed: 5030172
J Appl Physiol. 1971 Jan;30(1):99-115
pubmed: 5538799
Crit Care. 2007;11(1):114
pubmed: 17328793
N Engl J Med. 2000 May 4;342(18):1301-8
pubmed: 10793162
Crit Care Med. 2019 Sep;47(9):e774-e781
pubmed: 31162202
Crit Care. 2020 Aug 28;24(1):529
pubmed: 32859264
Intensive Care Med. 2005 Jun;31(6):776-84
pubmed: 15812622
Infect Agent Cancer. 2021 May 17;16(1):34
pubmed: 34001199
Am J Respir Crit Care Med. 2021 Apr 15;203(8):1025-1027
pubmed: 33560931
Vet Anaesth Analg. 2008 Mar;35(2):122-31
pubmed: 18179654
Am J Respir Crit Care Med. 2011 Sep 1;184(5):561-8
pubmed: 21562125
Intensive Care Med. 2015 Feb;41(2):222-30
pubmed: 25476984
Am J Respir Crit Care Med. 2018 Jul 1;198(1):131-134
pubmed: 29466674
Lancet. 1967 Aug 12;2(7511):319-23
pubmed: 4143721
Lancet Respir Med. 2020 May;8(5):433-434
pubmed: 32203709
Curr Opin Crit Care. 2017 Feb;23(1):24-29
pubmed: 27906708
J Appl Physiol. 1975 Mar;38(3):411-7
pubmed: 1150554
Am J Respir Crit Care Med. 2001 Sep 1;164(5):795-801
pubmed: 11549535
JAMA. 2016 Feb 23;315(8):788-800
pubmed: 26903337
Ann Transl Med. 2021 Dec;9(23):1715
pubmed: 35071409
Lancet. 2012 Jan 21;379(9812):229-35
pubmed: 22166903
Am Rev Respir Dis. 1989 May;139(5):1169-74
pubmed: 2653150
J Appl Physiol. 1970 May;28(5):596-608
pubmed: 5442255
N Engl J Med. 2017 Nov 9;377(19):1904-1905
pubmed: 29117492
Respir Physiol. 1973 Apr;17(3):347-64
pubmed: 4634023
Lancet Respir Med. 2020 Dec;8(12):1201-1208
pubmed: 32861276
J Appl Physiol (1985). 2020 Jun 1;128(6):1594-1603
pubmed: 32352339
J Appl Physiol (1985). 2001 Jun;90(6):2088-93
pubmed: 11356770
Am J Respir Crit Care Med. 1999 Apr;159(4 Pt 1):1172-8
pubmed: 10194162
Am J Respir Crit Care Med. 2012 Apr 1;185(7):702-8
pubmed: 22227381
Am J Respir Crit Care Med. 2001 Jul 1;164(1):131-40
pubmed: 11435251
Crit Care Med. 1993 Jan;21(1):78-83
pubmed: 8420734
Am J Respir Crit Care Med. 2014 Jan 15;189(2):149-58
pubmed: 24261322
Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):538-43
pubmed: 1892292
Anesthesiology. 2020 Oct 1;133(4):867-878
pubmed: 32701573
Acta Anaesthesiol Scand. 1989 Nov;33(8):629-37
pubmed: 2588994
Am J Pathol. 1976 Oct;85(1):209-28
pubmed: 788524
Crit Care Med. 2000 Dec;28(12):3837-42
pubmed: 11153623
Am J Respir Crit Care Med. 2013 Apr 1;187(7):761-7
pubmed: 23370917
Am J Respir Crit Care Med. 2018 Jan 1;197(1):132-136
pubmed: 28557528
Am J Respir Crit Care Med. 2010 Mar 15;181(6):578-86
pubmed: 19910610
Lancet Respir Med. 2020 Jul;8(7):681-686
pubmed: 32473124
Intensive Care Med. 2006 Jun;32(6):894-8
pubmed: 16601961
JAMA. 2012 Jun 20;307(23):2526-33
pubmed: 22797452
Thorax. 2008 Mar;63(3):215-20
pubmed: 17951278
Am J Respir Crit Care Med. 1994 May;149(5):1327-34
pubmed: 8173774
Am J Respir Crit Care Med. 2000 May;161(5):1590-6
pubmed: 10806160
Intensive Care Med. 1987;13(1):19-25
pubmed: 3558932
Am J Respir Crit Care Med. 1998 Jul;158(1):194-202
pubmed: 9655729
Intensive Care Med. 2015 Jun;41(6):1099-102
pubmed: 25527375
Am J Respir Crit Care Med. 2006 Feb 1;173(3):281-7
pubmed: 16254268
J Appl Physiol. 1972 Nov;33(5):568-75
pubmed: 4635918
Intensive Care Med. 2013 Nov;39(11):1909-15
pubmed: 24026295
Am J Respir Crit Care Med. 2004 Apr 15;169(8):957-62
pubmed: 14764430
Intensive Care Med. 2020 Jun;46(6):1124-1126
pubmed: 32328726
J Appl Physiol. 1968 Nov;25(5):566-74
pubmed: 5687363
Ann Thorac Surg. 2014 Oct;98(4):1254-60
pubmed: 25069683
Am J Respir Crit Care Med. 2001 Jan;163(1):69-78
pubmed: 11208628
Intensive Care Med. 2006 Dec;32(12):1979-86
pubmed: 17019545
Am J Respir Crit Care Med. 2020 May 15;201(10):1294-1297
pubmed: 32200645
Am J Respir Crit Care Med. 2020 Nov 1;202(9):1301-1304
pubmed: 32857595
Acta Anaesthesiol Scand. 1980 Jun;24(3):199-205
pubmed: 7004048
Intensive Care Med. 2021 Sep;47(9):1044-1046
pubmed: 34181043
Ann Intensive Care. 2020 May 12;10(1):55
pubmed: 32399901
J Appl Physiol. 1967 Mar;22(3):441-52
pubmed: 6020226