title: Pressure-regulated volume control vs. volume control ventilation in healthy and injured rabbit lung: An experimental study.
abstract: BACKGROUND
  It is not well understood how different ventilation modes affect the regional distribution of ventilation, particularly within the injured lung.
  
  
  OBJECTIVE
  We compared respiratory mechanics, lung aeration and regional specific ventilation ((Equation is included in full-text article.)) distributions in healthy and surfactant-depleted rabbits ventilated with pressure-regulated volume control (PRVC) mode with a decelerating inspiratory flow or with volume control (VC) mode.
  
  
  METHODS
  Randomised experimental study.
  
  
  METHODS
  New Zealand white rabbits (n = 8) were anaesthetised, paralysed and mechanically ventilated either with VC or PRVC mode (tidal volume: 7 ml kg; rate: 40 min; positive end-expiratory pressure (PEEP): 3 cmH2O), at baseline and after lung injury induced by lung lavage.
  
  
  METHODS
  Airway resistance (Raw), respiratory tissue damping (G) and elastance (H) were measured by low-frequency forced oscillations. Synchrotron radiation computed tomography during stable xenon wash-in was used to measure regional lung aeration and specific ventilation and the relative fraction of nonaerated, trapped, normally, poorly and hyperinflated lung regions.
  
  
  RESULTS
  Lung lavage significantly elevated peak inspiratory pressure (PIP) (P < 0.001). PIP was lower on PRVC compared with VC mode (-12.7 ± 1.7%, P < 0.001). No significant differences in respiratory mechanics, regional ventilation distribution, strain or blood oxygenation could be detected between the two ventilation modes.
  
  
  CONCLUSIONS
  A decelerating flow pattern (PRVC) resulted in equivalent regional ventilation distribution, respiratory mechanics and gas exchange, in both normal and mechanically heterogeneous lungs with, however, a significantly lower peak pressure. Our data suggest that the lower PIP on PRVC ventilation was because of the decelerating flow pattern rather than the ventilation distribution.
authors.affiliation: From the Department of Physics, University of Helsinki (LP, SS), Helsinki University Central Hospital, Helsinki, Finland (LP, SS), Université de Picardie Jules Verne, Inserm U1105 and Paediatric Lung Function Laboratory, CHU Amiens, Amiens, France (SB, LB), Anesthesiological Investigation Unit, University of Geneva, Geneva, Switzerland (IM, GA, CD), Biomedical Beamline-ID17, European Synchrotron Radiation Facility, Grenoble, France (LB), Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary (FP), Geneva Children's Hospital, University Hospitals of Geneva and Geneva University, Geneva, Switzerland (WH).
authors.forename: Liisa
authors.initials: L
authors.lastname: Porra
authors.forename: Sam
authors.initials: S
authors.lastname: Bayat
authors.forename: Iliona
authors.initials: I
authors.lastname: Malaspinas
authors.forename: Gergely
authors.initials: G
authors.lastname: Albu
authors.forename: Camille
authors.initials: C
authors.lastname: Doras
authors.forename: Ludovic
authors.initials: L
authors.lastname: Broche
authors.forename: Satu
authors.initials: S
authors.lastname: Strengell
authors.forename: Ferenc
authors.initials: F
authors.lastname: Peták
authors.forename: Walid
authors.initials: W
authors.lastname: Habre
mesh_terms: D055371:Acute Lung Injury / Q000503:physiopathology* / Q000628:therapy*; D000818:Animals; D008168:Lung / Q000502:physiology*; D008297:Male; D011175:Positive-Pressure Respiration / Q000379:methods; D011312:Pressure; D011817:Rabbits; D011897:Random Allocation; D012121:Respiration, Artificial / Q000379:methods*; D015656:Respiratory Mechanics / Q000502:physiology*; D013990:Tidal Volume / Q000502:physiology*