Simultaneous three-dimensional optical coherence tomography and intravital microscopy for imaging subpleural pulmonary alveoli in isolated rabbit lungs.

There is a growing interest in analyzing lung mechanics at the level of the alveoli in order to understand stress-related pathogenesis and possibly avoid ventilator associated lung injury. Emerging quantitative models to simulate fluid mechanics and the associated stresses and strains on delicate alveolar walls require realistic quantitative input on alveolar geometry and its dynamics during ventilation. Here, three-dimensional optical coherence tomography (OCT) and conventional intravital microscopy are joined in one setup to investigate the geometric changes of subpleural alveoli during stepwise pressure increase and release in an isolated and perfused rabbit lung model. We describe good qualitative agreement and quantitative correlation between the OCT data and video micrographs. Our main finding is the inflation and deflation of individual alveoli with noticeable hysteresis. Importantly, this three-dimensional geometry data can be extracted and converted into input data for numerical simulations.

[1]  L Puybasset,et al.  Computed tomography assessment of positive end-expiratory pressure-induced alveolar recruitment in patients with acute respiratory distress syndrome. , 2001, American journal of respiratory and critical care medicine.

[2]  M. Matthay,et al.  Science review: Mechanisms of ventilator-induced injury , 2002, Critical care.

[3]  C. E. Perlman,et al.  Alveolar expansion imaged by optical sectioning microscopy. , 2007, Journal of applied physiology.

[4]  G. Nieman,et al.  Altered alveolar mechanics in the acutely injured lung , 2001, Critical care medicine.

[5]  Gary Nieman,et al.  Dynamic alveolar mechanics and ventilator-induced lung injury , 2005, Critical care medicine.

[6]  G. Nieman,et al.  Correlation between alveolar recruitment /derecruitment and inflection points on the pressure-volume curve , 2007, Intensive Care Medicine.

[7]  Geoffrey McLennan,et al.  Alveolar dynamics during respiration: are the pores of Kohn a pathway to recruitment? , 2008, American journal of respiratory cell and molecular biology.

[8]  B Jonson,et al.  Elastic pressure–volume curves: what information do they convey? , 1999, Thorax.

[9]  D. Schoenfeld,et al.  Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. , 2000, The New England journal of medicine.

[10]  In vivo three-dimensional Fourier domain optical coherence tomography of subpleural alveoli combined with intra vital microscopy in the mouse model , 2008 .

[11]  M. Brezinski.  Optical Coherence Tomography: Principles and Applications , 2006 .

[12]  Arnab Majumdar,et al.  Lung and alveolar wall elastic and hysteretic behavior in rats: effects of in vivo elastase treatment. , 2003, Journal of applied physiology.

[13]  John P Mugler,et al.  Functional MRI of the lung using hyperpolarized 3‐helium gas , 2004, Journal of magnetic resonance imaging : JMRI.

[14]  D. Altman,et al.  Measuring agreement in method comparison studies , 1999, Statistical methods in medical research.

[15]  G. Ripandelli,et al.  Optical coherence tomography. , 1998, Seminars in ophthalmology.

[16]  Edmund Koch,et al.  Imaging of the three-dimensional alveolar structure and the alveolar mechanics of a ventilated and perfused isolated rabbit lung with Fourier domain optical coherence tomography. , 2006, Journal of biomedical optics.

[17]  J. C. Norman,et al.  Dynamic alveolar mechanics as studied by videomicroscopy. , 1975, Respiration physiology.

[18]  R. Hubmayr,et al.  Perspective on lung injury and recruitment: a skeptical look at the opening and collapse story. , 2002, American journal of respiratory and critical care medicine.