Maurizio F. Cereda1, Kiarash Emami2, Stephen J. Kadlecek2, Yi Xin2, Puttisarn Mongkolwisetwara2, Harilla Profka2, Amy Barulic2, Stephen Pickup2, Nicholas N. Kuzma2, Masaru Ishii3, Hooman Hamedani2, Benjamin M. Pullinger2, Rajat Ghosh2, Jennia Rajaei2, Clifford S. Deutschman1, Rahim R. Rizi2
1Anesthesiology & Critical Care, University of Pennsylvania, Philadelphia, PA, United States; 2Radiology, University of Pennsylvania, Philadelphia, PA, United States; 3OtolaryngologyHead & Neck Surgery, Johns Hopkins University, Baltimore, MD, United States
Positive end expiratory pressure (PEEP) protects surfactant deficient lungs from lung injury during mechanical ventilation. The mechanisms of this effect have not been established at the alveolar level. We used hyperpolarized gas MRI to quantify the effects of PEEP on lung microstructure on the alveolar and distal airspace level in surfactant deficient lungs. We show that, in spite of the increase in inspiratory pressures, PEEP alleviates airspace overdistension caused by surfactant deficiency. This technique can provide unique pathophysiological insight in the mechanisms of ventilator-associated lung injury.