2. METODOLOGÍAS EXPERIMENTALES PARA DETERMINAR
2.4. Procedimiento de cálculo de pérdidas por evaporación en tanques de
2.4.2. Procedimiento de cálculo de pérdidas por accesorios en la cubierta
Ultrasound is an inexpensive and ubiquitous tool that emits high-frequency sound waves (1-10MHz) through tissue and measures its reflection using piezoelectric sensors to characterize the acoustic properties of that tissue. While not traditionally used for lung imaging, recent studies suggest that ultrasound imaging is capable of detecting non-aerated areas and edematous regions of the lungs35. What is more, ultrasound imaging offers the
dual advantages of using portable scanners and visualizing the changes in lung aeration in real-time. However, it also offers suffers from diagnostic error and poor specificity, though these disadvantages can be limited by properly training the operator as well as by developing probes that are specifically designed for lung ultrasound35.
Another recently developed method for imaging the lungs is electrical impedance tomography (EIT), which uses several electrodes positioned around the chest to conduct a small alternating electrical current through the body in order to estimate the impedance across the thorax35. This impedance drastically changes in well-aerated areas during a
respiratory cycle, thereby localizing such areas. EIT currently suffers from low spatial resolution. However, it offers tremendous potential as an imaging tool, since it is
inexpensive and can be used to obtain images in real-time. Information provided by EIT could potentially be used to adjust the ventilator strategy for each patient at point-of-care35.
3.5. References
1. Kellum, J. A., Kramer, D. J. & Lee, K. Release of lactate by the lung in acute lung injury. Chest
(1997).
2. De Backer, D., Creteur, J., Zhang, H., Norrenberg, M. & Vincent, J. L. Lactate production by the lungs in acute lung injury. Am J Respir Crit Care Med156, 1099–1104 (1997).
3. Bassett, D. J. & Fisher, A. B. Alterations of glucose metabolism during perfusion of rat lung with paraquat. Am. J. Physiol.234, E653–9 (1978).
4. Pourfathi, M., Cereda, M., Chatterjee, S., reports, Y. X. S.2018. Lung Metabolism and Inflammation during Mechanical Ventilation; An Imaging Approach. nature.com, 8, 280 (2018).
5. Shaghaghi, H. et al. Metabolic spectroscopy of inflammation in a bleomycin‐induced lung injury model using hyperpolarized 1‐13C pyruvate. NMR Biomed.27, 939–947 (2014).
6. Pullinger, B. et al. Metabolism of hyperpolarized [1-13C]pyruvate in the isolated perfused rat lung - an ischemia study. NMR Biomed. n/a–n/a (2012). doi:10.1002/nbm.2777
7. Bassett, D. J. & Bowen-Kelly, E. Pyruvate metabolism of perfused rat lungs after exposure to 100% oxygen. J. Appl. Physiol.60, 1605–1609 (1986).
8. Iscra, F., Gullo, A. & Biolo, G. Bench-to-bedside review: Lactate and the lung. Crit Care6, 327– 329 (2002).
9. Routsi, C. & Bardouniotou, H. Pulmonary lactate release in patients with acute lung injury is not attributable to lung tissue hypoxia. Critical Care 2014 18:5 (1999).
10. Johnson, M. L., Hussien, R., Horning, M. A. & Brooks, G. A. Transpulmonary pyruvate kinetics.
AJP: Regulatory, Integrative and Comparative Physiology301, R769–R774 (2011).
11. Johnson, M. L., Emhoff, C. A. W., Horning, M. A. & Brooks, G. A. Transpulmonary lactate shuttle.
AJP: Regulatory, Integrative and Comparative Physiology302, R143–R149 (2011).
12. Thompson, B. T., of, R. C. N. E. J.2017. Acute respiratory distress syndrome. Mass Medical Soc,
377, 562–572 (2017).
13. Force, T. A. D. T. Acute Respiratory Distress Syndrome: The Berlin DefinitionThe Berlin Definition of ARDS. JAMA307, 2526–2533 (2012).
14. Shankar-Hari, M. & McAuley, D. F. Acute Respiratory Distress Syndrome Phenotypes and Identifying Treatable Traits. The Dawn of Personalized Medicine for ARDS. Am J Respir Crit Care
Med (2017). doi:10.1164/rccm.201608-
1729ED;journal:journal:ajrccm;issue:issue:10.1164/ajrccm.2017.195.issue- 3;wgroup:string:Default
15. ASHBAUGH, D. G., BIGELOW, D. B., PETTY, T. L. & LEVINE, B. E. Acute Respiratory Distress in Adults. The Lancet2, 319–+ (1967).
16. Herridge, M. S. 50 Years of Research in ARDS.Long-term Follow-up After ARDS: Insights for Managing Medical Complexity After Critical Illness. Am J Respir Crit Care Med rccm.201704–
17. Matute-Bello, G., Frevert, C. W. & Martin, T. R. Animal models of acute lung injury. American Journal of Physiology - Lung Cellular and Molecular Physiology295, L379–L399 (2008). 18. Guerin, C. et al. Prone Positioning in Severe Acute Respiratory Distress Syndrome. N Engl J Med
368, 2159–2168 (2013).
19. Grasso, S. et al. ARDSnet Ventilatory Protocol and Alveolar Hyperinflation. Am J Respir Crit Care Med176, 761–767 (2007).
20. Xin, Y. et al. Unstable Inflation Causing Injury: Insight from Prone Position and Paired CT Scans.
Am J Respir Crit Care Med rccm.201708–1728OC (2018). doi:10.1164/rccm.201708-1728OC 21. Rhoades, R. A. & David, B. Medical physiology, Principles for Clinical Medicine. (Wolters
Kluwer).
22. Slutsky, A. S. & Ranieri, V. M. Ventilator-Induced Lung Injury. N Engl J Med369, 2126–2136 (2013).
23. Khemani, R. G. et al. Positive End-Expiratory Pressure Lower Than the ARDS Network Protocol Is Associated with Higher Pediatric Acute Respiratory Distress Syndrome Mortality. Am J Respir Crit Care Med198, 77–89 (2018).
24. Sahetya, S. K., Goligher, E. C. & Brower, R. G. Fifty Years of Research in ARDS. Setting Positive End-Expiratory Pressure in Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med195,
1429–1438 (2017).
25. Jochen Grommes, O. S. Contribution of Neutrophils to Acute Lung Injury. Molecular Medicine17,
293–307 (2011).
26. Fisher, A. B., Steinberg, H. & Bassett, M. D. D. Energy utilization by the lung. Symposium on the Lung and Pulmonary Circulation57, 437–446 (1974).
27. Fisher, A. B. Intermediary metabolism of the lung. Environmental Health Perspectives 55, 149 (1984).
28. Johnson, M. L. Transpulmonary Lactate and Pyruvate Kinetics. (2011).
29. MURRAY, J. F., Matthay, M. A., LUCE, J. M. & FLICK, M. R. An Expanded Definition of the Adult Respiratory-Distress Syndrome. American Review of Respiratory Disease 138, 720–723 (1988).
30. Laffey, J. G. & Kavanagh, B. P. Fifty Years of Research in ARDS.Insight into Acute Respiratory Distress Syndrome. From Models to Patients. Am J Respir Crit Care Med196, 18–28 (2017). 31. Kennedy, T. P. et al. Acute acid aspiration lung injury in the rat: biphasic pathogenesis. Anesth.
Analg.69, 87–92 (1989).
32. Xin, Y. et al. Unstable Inflation Causing Injury. Insight from Prone Position and Paired Computed Tomography Scans. Am J Respir Crit Care Med198, 197–207 (2018).
33. Thorneloe, K. S. et al. An Orally Active TRPV4 Channel Blocker Prevents and Resolves Pulmonary Edema Induced by Heart Failure. Science Translational Medicine4, 159ra148–159ra148 (2012). 34. Calfee, C. S. Precision Medicine: An Opportunity to Improve Outcomes of Patients With Sepsis.
35. Cereda, M. et al. Imaging the Injured Lung: Mechanisms of Action and Clinical Use. (2019). 36. Cereda, M. et al. Tidal changes on CT and progression of ARDS. Thorax thoraxjnl–2016–209833
(2017). doi:10.1136/thoraxjnl-2016-209833
37. Fuld, M. K. et al. Pulmonary Perfused Blood Volume with Dual-Energy CT as Surrogate for Pulmonary Perfusion Assessed with Dynamic Multidetector CT. Radiology267, 747–756 (2013). 38. Pauwels, E. K., Sturm, E. J., Bombardieri, E., Cleton, F. J. & Stokkel, M. P. Positron-emission
tomography with [18F]fluorodeoxyglucose. Part I. Biochemical uptake mechanism and its implication for clinical studies. J. Cancer Res. Clin. Oncol.126, 549–559 (2000).
39. Miles, K. A., Voo, S. A. & Groves, A. M. Additional Clinical Value for PET/MRI in Oncology: Moving Beyond Simple Diagnosis. J. Nucl. Med.59, 1028–1032 (2018).
40. de Prost, N. et al. 18F-FDG kinetics parameters depend on the mechanism of injury in early experimental acute respiratory distress syndrome. - PubMed - NCBI. J. Nucl. Med.55, 1871–1877 (2014).
41. Rodrigues, R. S. et al. FDG-PET in patients at risk for acute respiratory distress syndrome: a preliminary report. Intensive Care Med34, 2273–2278 (2008).
42. Locke, L. W. et al. FDG-PET Quantification of Lung Inflammation with Image-Derived Blood Input Function in Mice. International Journal of Molecular Imaging2011, 1–6 (2011).
43. Bellani, G. et al. Lungs of patients with acute respiratory distress syndrome show diffuse inflammation in normally aerated regions: A [18F]-fluoro-2-deoxy-D-glucose PET/CT study.
Critical Care Medicine37, 2216–2222 (2009).
44. Jiang, W. et al. Motion robust high resolution 3D free‐breathing pulmonary MRI using dynamic 3D image self‐navigator. Magn. Reson. Med.79, 2954–2967 (2018).
45. Ley, S. & Ley-Zaporozhan, J. Pulmonary perfusion imaging using MRI: clinical application.
Insights into Imaging3, 61–71 (2011).
46. Ruppert, K. Biomedical imaging with hyperpolarized noble gases. Rep. Prog. Phys.77, 116701 (2014).
47. Mugler, J. P. & Altes, T. A. Hyperpolarized 129Xe MRI of the human lung. J. Magn. Reson. Imaging37, 313–331 (2013).
48. Cereda, M. et al. Quantitative imaging of alveolar recruitment with hyperpolarized gas MRI during mechanical ventilation. J. Appl. Physiol.110, 499–511 (2011).
49. Ouriadov, A. et al. Early stage radiation-induced lung injury detected using hyperpolarized 129Xe Morphometry: Proof-of-concept demonstration in a rat model. Magn. Reson. Med. n/a–n/a (2015). doi:10.1002/mrm.25825
50. Li, H. et al. Quantitative evaluation of radiation‐induced lung injury with hyperpolarized xenon magnetic resonance. Magn. Reson. Med. n/a–n/a (2015). doi:10.1002/mrm.25894