High VT Research Articles

Rats surviving injurious mechanical ventilation show reversible pulmonary, vascular and inflammatory changes

To describe the time course of the changes in pulmonary and vascular function, and systemic inflammation induced by injurious mechanical ventilation. Experimental study in an animal model of ventilator-induced lung injury. Animal research laboratory. Anesthetized male adult Sprague-Dawley rats were ventilated with VT 9 ml/kg and PEEP 5 cmH2O, or VT 35 ml/kg and zero PEEP for 1 h, and were killed. Other rats received ventilation for 1 h with high VT, to observe survival (n=36), or to be monitored and killed at different points in time (24, 72 and 168 h; n=7 in each group). Blood samples for measuring biochemical parameters were obtained. Post-mortem, a bronchoalveolar lavage (BAL) was performed, the aorta and pulmonary microvessels were isolated to examine ex-vivo vascular responses and pulmonary slices were examined (light microscopy). Mortality in rats ventilated with high VT was 19 of 36 (54%). Mechanical ventilation was associated with hypotension, hypoxaemia and membrane hyaline formation. AST, ALT, IL-6, MIP-2 serum and BAL fluid concentrations, as well as VEGF BAL fluid concentration, were increased in rats ventilated with high VT. Lung injury score was elevated. Aortic vascular responses to acetylcholine and norepinephrine, and microvascular responses to acetylcholine, were impaired. These changes resolved by 24-72 h. Injurious ventilation is associated with respiratory and vascular dysfunction, accompanied by pulmonary and systemic inflammation. The survival rate was about 50%. In survivors, most induced changes completely normalized by 24-72 h after the insult.

VENTILATOR-INDUCED INJURY AUGMENTS INTERLEUKIN-1β PRODUCTION AND NEUTROPHIL SEQUESTRATION IN LIPOPOLYSACCHARIDE-TREATED LUNGS

Mechanical ventilators are commonly used to support critically ill patients; however, inappropriate ventilator settings might initiate or augment lung injury. To determine whether a large tidal volume (Vt) augments inflammatory responses and neutrophil sequestration in the lungs of rats receiving intratracheal lipopolysaccharides (LPS). Rats received intratracheal instillation of LPS (0.5 mg/kg) followed by 4 h of mechanical ventilation (MV) at 60 strokes per min with a Vt of 10 mL/kg as control MV, or 30 strokes per min with a Vt of 20 mL/kg of body weight as high-volume MV (HMV). In addition, monoclonal antibodies against rat intercellular adhesion molecule 1 (ICAM-1) or immunoglobulin G (50 mg/kg) were administered 30 min before LPS instillation and MV. Our study demonstrates that HMV enhances pulmonary permeability and induces neutrophil recruitment into the alveolar space and pulmonary edema. Intratracheal instillation of LPS caused marked lung injury, neutrophil recruitment, and production of cytokines and chemokines. Combining LPS instillation and HMV synergistically upregulated interleukin 1beta (IL-1beta) production and neutrophil sequestration in lung tissues. The ICAM-1 expression in lung tissues was responsible for the synergistic effects of neutrophil sequestration. Synergistic upregulation of IL-1beta production and neutrophil sequestration was attenuated by blocking ICAM-1 by neutralizing antibody pretreatment. High Vt MV in LPS-injured lung causes synergistic production of IL-1beta and sequestration of neutrophil via ICAM-1-dependent effects.

Exacerbation of wood smoke-induced acute lung injury by mechanical ventilation using moderately high tidal volume in mice

We investigated the effects of mechanical ventilation with a moderately high tidal volume (VT) on acute lung injury (ALI) induced by wood smoke inhalation in anesthetized mice. Animals received challenges of air, 30 breaths of smoke (30SM) or 60 breaths of smoke (60SM) and were then ventilated with a VT of 10 ml/kg (10VT) or 16 ml/kg (16VT). After 4-h mechanical ventilation, the bronchoalveolar-capillary permeability, pulmonary infiltration of inflammatory cells, total lung injury score and pulmonary expressions of interleukin-1beta and macrophage inflammatory protein-2 mRNA and proteins in the 30SM+16VT and 60SM+16VT groups were greater than those in the 30SM+10VT and 60SM+10VT groups, respectively. Additionally, the wet/dry weight ratio of lung tissues and lung epithelial cell apoptosis in the 60SM+16VT group were greater than those in the 60SM+10VT group. These differences between the 16VT and 10VT groups were not seen in animals with air challenge. Thus, mechanical ventilation with a moderately high VT in mice exacerbates ALI induced by wood smoke inhalation.

Impact of low and high tidal volumes on the rat alveolar epithelial type II cell proteome.

Mechanical ventilation with high tidal volumes leads to increased permeability, generation of inflammatory mediators, and damage to alveolar epithelial cells (ATII). To identify changes in the ATII proteome after two different ventilation strategies in rats. Rats (n = 6) were ventilated for 5 hours with high- and low tidal volumes (VTs) (high VT: 20 ml/kg; low VT: 6 ml/kg). Pooled nonventilated rats served as control animals. ATII cells were isolated and lysed, and proteins were tryptically cleaved into peptides. Cellular protein content was evaluated by peptide labeling of the ventilated groups with (18)O. Samples were fractionated by cation exchange chromatography and identified using electrospray tandem mass spectrometry. Proteins identified by 15 or more peptides were statistically compared using t tests corrected for the false discovery rate. High Vt resulted in a significant increase in airspace neutrophils without an increase in extravascular lung water. Compared with low-VT samples, high-VT samples showed a 32% decrease in the inositol 1,4,5-trisphosphate 3 receptor (p < 0.01), a 34% decrease in Na(+), K(+)-ATPase (p < 0.01), and a significantly decreased content in ATP synthase chains. Even low-VT samples displayed significant changes, including a 66% decrease in heat shock protein 90-beta (p < 0.01) and a 67% increase in mitochondrial pyruvate carboxylase (p < 0.01). Significant differences were found in membrane, acute phase, structural, and mitochondrial proteins. After short-term exposure to high-VT ventilation, significant reductions in membrane receptors, ion channel proteins, enzymes of the mitochondrial energy system, and structural proteins in ATII cells were present. The data supports the two-hit concept that an unfavorable ventilatory strategy may make the lung more vulnerable to an additional insult.

Effect of positive end-expiratory pressure and tidal volume on lung injury induced by alveolar instability.

IntroductionOne potential mechanism of ventilator-induced lung injury (VILI) is due to shear stresses associated with alveolar instability (recruitment/derecruitment). It has been postulated that the optimal combination of tidal volume (Vt) and positive end-expiratory pressure (PEEP) stabilizes alveoli, thus diminishing recruitment/derecruitment and reducing VILI. In this study we directly visualized the effect of Vt and PEEP on alveolar mechanics and correlated alveolar stability with lung injury.MethodsIn vivo microscopy was utilized in a surfactant deactivation porcine ARDS model to observe the effects of Vt and PEEP on alveolar mechanics. In phase I (n = 3), nine combinations of Vt and PEEP were evaluated to determine which combination resulted in the most and least alveolar instability. In phase II (n = 6), data from phase I were utilized to separate animals into two groups based on the combination of Vt and PEEP that caused the most alveolar stability (high Vt [15 cc/kg] plus low PEEP [5 cmH2O]) and least alveolar stability (low Vt [6 cc/kg] and plus PEEP [20 cmH2O]). The animals were ventilated for three hours following lung injury, with in vivo alveolar stability measured and VILI assessed by lung function, blood gases, morphometrically, and by changes in inflammatory mediators.ResultsHigh Vt/low PEEP resulted in the most alveolar instability and lung injury, as indicated by lung function and morphometric analysis of lung tissue. Low Vt/high PEEP stabilized alveoli, improved oxygenation, and reduced lung injury. There were no significant differences between groups in plasma or bronchoalveolar lavage cytokines or proteases.ConclusionA ventilatory strategy employing high Vt and low PEEP causes alveolar instability, and to our knowledge this is the first study to confirm this finding by direct visualization. These studies demonstrate that low Vt and high PEEP work synergistically to stabilize alveoli, although increased PEEP is more effective at stabilizing alveoli than reduced Vt. In this animal model of ARDS, alveolar instability results in lung injury (VILI) with minimal changes in plasma and bronchoalveolar lavage cytokines and proteases. This suggests that the mechanism of lung injury in the high Vt/low PEEP group was mechanical, not inflammatory in nature.

Threshold Voltage Control in PMOSFETs with Polysilicon or Fully-Silicided Gates on Hf-Based Gate Dielectric Using Controlled Lateral Oxidation

Large threshold-voltage (Vt) shifts are seen in PMOSFETs with Hf-based highK gate dielectric and polysilicon gates. The polysilicon-highK interface can be modified by introducing a thin interfacial oxide layer using a controlled lateral oxidation (CLO) step after gate patterning. This can reduce the threshold voltage shift to within 0.1V of SiO2 reference for devices with gate length <1mm. The benefit of lower Vt with the lateral oxidation comes at the expense of increased EOT. We therefore tried CLO using fully-silicided NiSi gates since the poly-depletion gain can offset the EOT increase. Our results show that the Vt difference between SiO2 and HfSiO is within 50mV. Moreover, the Ion-Ioff performance shows that while poly gates are lower in performance due to high Vt, the FUSI gates give Ion/Ioff at 1.1V of 180 (μA/μm)/20 (pA/μm) for both Hf- silicates and conventional SiO2. Interfacial modification using CLO can be a potential integration solution for highK gate dielectrics with polysilicon gates.

Choosing the frequency of deep inflation in mice: balancing recruitment against ventilator-induced lung injury

Low tidal volume (Vt) ventilation is protective against ventilator-induced lung injury but can promote development of atelectasis. Periodic deep inflation (DI) can open the lung, but if delivered too frequently may cause damage via repeated overdistention. We therefore examined the effects of varying DI frequency on lung mechanics, gas exchange, and biomarkers of injury in mice. C57BL/6 males were mechanically ventilated with positive end-expiratory pressure (PEEP) of 2 cmH2O for 2 h. One high Vt group received a DI with each breath (HV). Low Vt groups received 2 DIs after each hour of ventilation (LV) or 2 DIs every minute (LVDI). Control groups included a nonventilated surgical sham and a group receiving high Vt with zero PEEP (HVZP). Respiratory impedance was measured every 4 min, from which tissue elastance (H) and damping (G) were derived. G and H rose progressively during LV and HVZP, but returned to baseline after hourly DI during LV. During LVDI and HV, G and H remained low and gas exchange was superior to that of LV. Bronchoalveolar lavage fluid protein was elevated in HV and HVZP but was not different between LV and LVDI. Lung tissue IL-6 and IL-1beta levels were elevated in HVZP and lower in LVDI compared with LV. We conclude that frequent DI can safely improve gas exchange and lung mechanics and may confer protection from biotrauma. Differences between LVDI and HV suggest that an optimal frequency range of DI exists, within which the benefits of maintaining an open lung outweigh injury incurred from overdistention.

Evidence for a seismic activity mainly constituted of hybrid events at Cayambe volcano, Ecuador. Interpretation in a iced-domes volcano context

The high activity level of Hybrid Events (HE) detected beneath the Cayambe volcano since 1989 has been more thoroughly investigated with data from a temporary array. The unusual HE spectral content allows separating a high-frequency signal riding on a low-frequency one, with a probable single source. HEs are interpreted as high frequency VT events, produced by the interaction between magmatic heat and an underground water system fed by thaw water from the summital glacier, which trigger simultaneous low-frequency fluid resonance in the highly fractured adjacent medium. Pure VTs are interpreted as ‘aborted’ HEs occurring probably in the oldest and coldest part of the volcano complex. To cite this article: B. Guillier, J.-L. Chatelain, C. R. Geoscience 338 (2006).

Ventilator-induced lung injury is reduced in transgenic mice that overexpress endothelial nitric oxide synthase

Although mechanical ventilation (MV) is an important supportive strategy for patients with acute respiratory distress syndrome, MV itself can cause a type of acute lung damage termed ventilator-induced lung injury (VILI). Because nitric oxide (NO) has been reported to play roles in the pathogenesis of acute lung injury, the present study explores the effects on VILI of NO derived from chronically overexpressed endothelial nitric oxide synthase (eNOS). Anesthetized eNOS-transgenic (Tg) and wild-type (WT) C57BL/6 mice were ventilated at high or low tidal volume (Vt; 20 or 7 ml/kg, respectively) for 4 h. After MV, lung damage, including neutrophil infiltration, water leakage, and cytokine concentration in bronchoalveolar lavage fluid (BALF) and plasma, was evaluated. Some mice were given N(omega)-nitro-L-arginine methyl ester (L-NAME), a potent NOS inhibitor, via drinking water (1 mg/ml) for 1 wk before MV. Histological analysis revealed that high Vt ventilation caused severe VILI, whereas low Vt ventilation caused minimal VILI. Under high Vt conditions, neutrophil infiltration and lung water content were significantly attenuated in eNOS-Tg mice compared with WT animals. The concentrations of macrophage inflammatory protein-2 in BALF and plasma, as well as plasma tumor necrosis factor-alpha and monocyte chemoattractant protein-1, also were decreased in eNOS-Tg mice. L-NAME abrogated the beneficial effect of eNOS overexpression. In conclusion, chronic eNOS overexpression may protect the lung from VILI by inhibiting the production of inflammatory chemokines and cytokines that are associated with neutrophil infiltration into the air space.

Increased Susceptibility to Ventilator-associated Lung Injury Persists after Clinical Recovery from Experimental Endotoxemia

Endotoxin, when delivered shortly before or during mechanical ventilation, increases susceptibility to ventilation-associated lung injury. However, it is unclear whether increased susceptibility to ventilator-associated lung injury is still present after clinical recovery from a transient endotoxin challenge. Anesthetized rats were submitted to a 4-h period of mechanical ventilation with low (8 ml/kg) or high (24, 27, or 30 ml/kg) tidal volumes (VTs) 24 h after transient illness had been provoked by a single nonlethal intravenous injection of Escherichia coli endotoxin. Control animals were injected with phosphate-buffered saline and underwent the same protocol. At 24 h, endotoxin-treated nonventilated animals showed no symptoms of clinical illness, and oxygenation was comparable with that of controls, but lung neutrophil counts were increased. Compared with controls, mechanical ventilation with high VT induced a stronger pulmonary inflammatory response and more severe lung injury in endotoxin-treated animals, as indicated by impaired oxygenation, increased lung wet-to-dry weight ratio, and increased levels of protein, neutrophils, and cytokines in lung lavage fluid. In addition, the highest VT resulted in increased mortality in endotoxin-treated animals. Low VT after endotoxin treatment did not cause functional pulmonary impairment but induced an inflammatory response. In this animal model, a 24-h delay after a single systemic injection of endotoxin resulted in clinical recovery and preserved pulmonary function but did not prevent increased susceptibility to ventilator-associated lung injury provoked by high VT. Residual pulmonary inflammation and neutrophilic infiltration at initiation of mechanical ventilation probably contribute to these findings.

The Pulmonary Immune Effects of Mechanical Ventilation in Patients Undergoing Thoracic Surgery

Mechanical ventilation (MV) may induce an inflammatory alveolar response. One-lung ventilation (OLV) with tidal volumes (Vt) as used during two-lung ventilation is a suggested algorithm but may impose mechanical stress of the dependent lung and potentially aggravate alveolar mediator release. We studied whether ventilation with different Vt modifies pulmonary immune function, hemodynamics, and gas exchange. Thirty-two patients undergoing open thoracic surgery were randomized to receive either MV with Vt = 10 mL/kg (n = 16) or Vt = 5 mL/kg (n = 16) adjusted to normal Pa(CO2) during and after OLV. Fiberoptic bronchoalveolar lavage of the ventilated lung was performed, and cells, protein, tumor necrosis factor (TNF)-alpha, interleukin (IL)-8, soluble intercellular adhesion molecule (sICAM)-1, IL-10, and elastase were determined in the bronchoalveolar lavage. Data were analyzed by parametric or nonparametric tests, as indicated. In all patients, an increase of proinflammatory variables was found. The time courses of intra-alveolar cells, protein, albumin, IL-8, elastase, and IL-10 did not differ between the groups after OLV and postoperatively. TNF-alpha (8.4 versus 5.0 microg/mL) and sICAM-1 (52.7 versus 27.5 microg/mL) concentrations were significantly smaller after OLV with Vt = 5 mL/kg. These results indicate that MV may induce epithelial damage and a proinflammatory response in the ventilated lung. Reduction of tidal volume during OLV may reduce alveolar concentrations of TNF-alpha and of sICAM-1. Reductions of tidal volume, with subsequently decreased peak airway pressures, may reduce some alveolar inflammatory responses seen with mechanical ventilation.

Time and tidal volume-dependent ventilator-induced lung injury in healthy rats

We evaluated the effect of duration of mechanical ventilation with different tidal volumes (VT) on ventilator-induced lung injury in healthy rats. Anaesthetized rats were ventilated with VT between 9 and 45 mL kg[-1] for 1 or 7 h with a positive end-expiratory pressure of 2.5 cmH2O. After 1 h, rats ventilated even with the highest applied VT (36 and 45 mL kg[minus sign]1, resulting in average peak airway pressures of 30 +/-3 and 37 +/- 4 cmH2O), had no detectable alterations in dynamic or static lung mechanics, gas exchange or pulmonary permeability, but a moderate degree of lung inflammation (neutrophil accumulation in broncho-alveolar lavage) observed in all groups. In contrast, after 3 h of ventilation, rats ventilated with the highest VT (36 and 45 mL kg[minus sign]1) died from progressive circulatory failure and high-permeability pulmonary oedema, manifested by hypoxaemia, an increased alveolar-arterial protein concentration ratio and a reduced static lung compliance (mortality rate at 7 h, 62.5% and 100%). Animals with lower VT all survived and presented no changes in the measured variables. These results in normal rats demonstrate the preponderant effect of the duration (>3 h) of 'aggressive' ventilation and the cut-off value of the level of VT applied (>27 mL kg[minus sign]1).

Leukotrienes in Acute Lung Injury

Leukotrienes in Acute Lung Injury

5-Lipoxygenase Deficiency Prevents Respiratory Failure during Ventilator-induced Lung Injury

Mechanical ventilation with high VT (HVT) progressively leads to lung injury and decreased efficiency of gas exchange. Hypoxic pulmonary vasoconstriction (HPV) directs blood flow to well-ventilated lung regions, preserving systemic oxygenation during pulmonary injury. Recent experimental studies have revealed an important role for leukotriene (LT) biosynthesis by 5-lipoxygenase (5LO) in the impairment of HPV by endotoxin. To investigate whether or not impairment of HPV contributes to the hypoxemia associated with HVT and to evaluate the role of LTs in ventilator-induced lung injury. We studied wild-type and 5LO-deficient mice ventilated for up to 10 hours with low VT (LVT) or HVT. In wild-type mice, HVT, but not LVT, increased pulmonary vascular permeability and edema formation, impaired systemic oxygenation, and reduced survival. HPV, as reflected by the increase in left pulmonary vascular resistance induced by left mainstem bronchus occlusion, was markedly impaired in animals ventilated with HVT. HVT ventilation increased bronchoalveolar lavage levels of LTs and neutrophils. In 5LO-deficient mice, the HVT-induced increase of pulmonary vascular permeability and worsening of respiratory mechanics were markedly attenuated, systemic oxygenation was preserved, and survival increased. Moreover, in 5LO-deficient mice, HVT ventilation did not impair the ability of left mainstem bronchus occlusion to increase left pulmonary vascular resistance. Administration of MK886, a 5LO-activity inhibitor, or MK571, a selective cysteinyl-LT(1) receptor antagonist, largely prevented ventilator-induced lung injury. These results indicate that LTs play a central role in the lung injury and impaired oxygenation induced by HVT ventilation.

Seismic signature of a phreatic explosion: hydrofracturing damage at Karthala volcano, Grande Comore Island, Indian Ocean

Karthala volcano is a basaltic shield volcano with an active hydrothermal system that forms the southern two-thirds of the Grande Comore Island, off the east coat of Africa, northwest of Madagascar. Since the start of volcano monitoring by the local volcano observatory in 1988, the July 11th, 1991 phreatic eruption was the first volcanic event seismically recorded on this volcano, and a rare example of a monitored basaltic shield. From 1991 to 1995 the VT locations, 0.5<Ml<4.3, show a crack shaped pattern (3 km long, 1 km wide) within the summit caldera extending at depth from –2 km to +2 km relative to sea level. This N-S elongated pattern coincides with the direction of the regional maximum horizontal stress as deduced from regional focal mechanism solutions. This brittle signature of the damage associated with the 1991 phreatic eruption is a typical pattern of the seismicity induced by controlled fluid injections such as those applied at geothermal fields, in oil and gas recovery, or for stress measurements. It suggests the 1991 phreatic eruption was driven by hydraulic fracturing induced by forced fluid flow. We propose that the extremely high LP and VT seismicity rates, relative to other effusive volcanoes, during the climax of the 1991 phreatic explosion, are due to the activation of the whole hydrothermal system, as roughly sized by the distribution of VT hypocenters. The seismicity rate in 1995 was still higher than the pre-eruption seismicity rate, and disagrees with the time pattern of thermo-elastic stress readjustment induced by single magma intrusions at basaltic volcanoes. We propose that it corresponds to the still ongoing relaxation of pressure heterogeneity within the hydrothermal system as suggested by the few LP events that still occurred in 1995.

Arm Cocking And Upper Torso Rotation Patterns Associated With Elbow Varus Torque In Baseball Pitching

PURPOSE To examine relationships among the shoulder horizontal abduction (HA) component of arm cocking, upper torso rotation, and the elbow maximum VT. METHODS A twelve-camera opto-electric system was used to collect kinematic data from 12 college and 8 high school pitchers. Joint kinematics and kinetics of three maximum effort strikes were averaged for each subject. A shoulder HA angle of zero meant that the upper arm was horizontal in the frontal plane. An upper torso angle of zero meant the lead shoulder was pointing directly towards home plate (throwing shoulder pointing towards second base). Subjects were divided into two groups based on the shoulder maximum HA angle achieved during arm cocking (high horizontal abduction HHA and low horizontal abduction LHA). Each group was then separated into high and low VT pitchers (top 5 and bottom 5). Two-way independent ANOVA (HA and VT) and independent t-tests were used to assess differences among pitchers (α=0.05). RESULTS Normalized elbow maximum VT varied substantially among all pitchers (1.2–4.6 % of body weight and height). No significant difference in VT was found between the HHA (3.21±0.81) and LHA (3.21±0.94) groups. However, the HHA group had significantly higher throwing velocity (80.7±3.2 mph) than the LHA group (75.9±3.2 mph). Two upper torso variables were assessed with respect to VT. First, high VT pitchers achieved a significantly greater upper torso maximum rotational angular velocity than low VT pitchers during the cocking phase (987±106°/s vs. 815±85°/s, respectively). Second, a univariate analysis revealed that high varus torque HHA pitchers achieved shoulder maximum HA at a significantly more open upper torso orientation (12.1±18.3°) than low varus torque HHA pitchers (−10.5±19.7°). CONCLUSIONS These results suggest that shoulder HA range of motion 1) may be an important factor in determining throwing velocity and 2) may have minimum influence on elbow VT. The elbow VT appears to be related to the timing of shoulder HA and upper torso rotation styles used during the arm cocking phase.

Pulmonary impedance and alveolar instability during injurious ventilation in rats

The mechanical derangements in the acutely injured lung have long been ascribed, in large part, to altered mechanical function at the alveolar level. This has not been directly demonstrated, however, so we investigated the issue in a rat model of overinflation injury. After thoracotomy, rats were mechanically ventilated with either 1) high tidal volume (Vt) or 2) low Vt with periodic deep inflations (DIs). Forced oscillations were used to measure pulmonary impedance every minute, from which elastance (H) and hysteresivity (eta) were derived. Subpleural alveoli were imaged every 15 min using in vivo video microscopy. Cross-sectional areas of individual alveoli were measured at peak inspiration and end exhalation, and the percent change was used as an index of alveolar instability (%I-EDelta). Low Vt never led to an increase in %I-EDelta but did result in progressive atelectasis that coincided with an increase in H but not eta. DI reversed atelectasis due to low Vt, returning H to baseline. %I-EDelta, H, and eta all began to rise by 30 min of high Vt and were not reduced by DI. We conclude that simultaneous increases in both H and eta are reflective of lung injury in the form of alveolar instability, whereas an isolated and reversible increase in H during low Vt reflects merely derecruitment of alveoli.

The Role of Hyaluronan Synthase 3 in Ventilator-induced Lung Injury

We recently found that low-molecular-weight hyaluronan was induced by cyclic stretch in lung fibroblasts and accumulated in lungs from animals with ventilator-induced lung injury. The low-molecular-weight hyaluronan produced by stretch increased interleukin-8 production in epithelial cells, and was accompanied by an upregulation of hyaluronan synthase-3 mRNA. We hypothesized that low-molecular-weight hyaluronan induced by high VT was dependent on hyaluronan synthase 3, and was associated with ventilator-induced lung injury. Effects of high VT ventilation in C57BL/6 wild-type and hyaluronan synthase-3 knockout mice were compared. Significantly increased neutrophil infiltration, macrophage inflammatory protein-2 production, and lung microvascular leak were found in wild-type animals ventilated with high VT. These reactions were significantly reduced in hyaluronan synthase-3 knockout mice, except the capillary leak. Wild-type mice ventilated with high VT were found to have increased low-molecular-weight hyaluronan in lung tissues and concomitant increased expression of hyaluronan synthase-3 mRNA, neither of which was found in hyaluronan synthase-3 knockout mice. We conclude that high VT induced low-molecular-weight hyaluronan production is dependent on de novo synthesis through hyaluronan synthase 3, and plays a role in the inflammatory response of ventilator-induced lung injury.

A forward body-biased low-leakage SRAM cache: device, circuit and architecture considerations

This paper presents a forward body-biasing (FBB) technique for active and standby leakage power reduction in cache memories. Unlike previous low-leakage SRAM approaches, we include device level optimization into the design. We utilize super high Vt (threshold voltage) devices to suppress the cache leakage power, while dynamically FBB only the selected SRAM cells for fast operation. In order to build a super high Vt device, the two-dimensional (2-D) halo doping profile was optimized considering various nanoscale leakage mechanisms. The transition latency and energy overhead associated with FBB was minimized by waking up the SRAM cells ahead of the access and exploiting the general cache access pattern. The combined device-circuit-architecture level techniques offer 64% total leakage reduction and 7.3% improvement in bit line delay compared to a previous state-of-the-art low-leakage SRAM technique. Static noise margin of the proposed SRAM cell is comparable to conventional SRAM cells.

A Mathematical Model of Alveolar Gas Exchange in Partial Liquid Ventilation

In partial liquid ventilation (PLV), perfluorocarbon (PFC) acts as a diffusion barrier to gas transport in the alveolar space since the diffusivities of oxygen and carbon dioxide in this medium are four orders of magnitude lower than in air. Therefore convection in the PFC layer resulting from the oscillatory motions of the alveolar sac during ventilation can significantly affect gas transport. For example, a typical value of the Péclet number in air ventilation is Pe approximately 0.01, whereas in PLV it is Pe approximately 20. To study the importance of convection, a single terminal alveolar sac is modeled as an oscillating spherical shell with gas, PFC, tissue and capillary blood compartments. Differential equations describing mass conservation within each compartment are derived and solved to obtain time periodic partial pressures. Significant partial pressure gradients in the PFC layer and partial pressure differences between the capillary and gas compartments (P(C)-Pg) are found to exist. Because Pe>> 1, temporal phase differences are found to exist between P(C)-Pg and the ventilatory cycle that cannot be adequately described by existing non-convective models of gas exchange in PLV The mass transfer rate is nearly constant throughout the breath when Pe>>1, but when Pe<<1 nearly 100% of the transport occurs during inspiration. A range of respiratory rates (RR), including those relevant to high frequency oscillation (HFO) +PLV, tidal volumes (V(T)) and perfusion rates are studied to determine the effect of heterogeneous distributions of ventilation and perfusion on gas exchange. The largest changes in P(C)O2 and P(C)CO2 occur at normal and low perfusion rates respectively as RR and V(T) are varied. At a given ventilation rate, a low RR-high V(T) combination results in higher P(C)O2, lower P(C)CO2 and lower (P(C)-Pg) than a high RR-low V(T) one.