{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,28]],"date-time":"2024-06-28T00:19:43Z","timestamp":1719533983640},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Normally aerated lung tissue on computed tomography (CT) is correlated with static respiratory system compliance (C<jats:sub>rs<\/jats:sub>) at zero end-expiratory pressure. In clinical practice, however, patients with acute respiratory failure are often managed using elevated PEEP levels. No study has validated the relationship between lung volume and tissue and C<jats:sub>rs<\/jats:sub> at the applied positive end-expiratory pressure (PEEP). Therefore, this study aimed to demonstrate the relationship between lung volume and tissue on CT and C<jats:sub>rs<\/jats:sub> during the application of PEEP for the clinical management of patients with acute respiratory distress syndrome due to COVID-19. Additionally, as a secondary outcome, the study aimed to evaluate the relationship between CT characteristics and C<jats:sub>rs<\/jats:sub>, considering recruitability using the recruitment-to-inflation ratio (R\/I ratio). We analyzed the CT and respiratory mechanics data of 30 patients with COVID-19 who were mechanically ventilated. The CT images were acquired during mechanical ventilation at PEEP level of 15 cmH<jats:sub>2<\/jats:sub>O and were quantitatively analyzed using Synapse Vincent system version 6.4 (Fujifilm Corporation, Tokyo, Japan). Recruitability was stratified into two groups, high and low recruitability, based on the median R\/I ratio of our study population. Thirty patients were included in the analysis with the median R\/I ratio of 0.71. A significant correlation was observed between C<jats:sub>rs<\/jats:sub> at the applied PEEP (median 15 [interquartile range (IQR) 12.2, 15.8]) and the normally aerated lung volume (r\u2009=\u20090.70 [95% CI 0.46\u20130.85], <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and tissue (r\u2009=\u20090.70 [95% CI 0.46\u20130.85], <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Multivariable linear regression revealed that recruitability (Coefficient\u2009=\u2009\u2212\u2009390.9 [95% CI \u2212\u2009725.0 to \u2212\u200956.8], <jats:italic>P<\/jats:italic>\u2009=\u20090.024) and C<jats:sub>rs<\/jats:sub> (Coefficient\u2009=\u200948.9 [95% CI 32.6\u201365.2], <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) were significantly associated with normally aerated lung volume (R-squared: 0.58). In this study, C<jats:sub>rs<\/jats:sub> at the applied PEEP was significantly correlated with normally aerated lung volume and tissue on CT. Moreover, recruitability indicated by the R\/I ratio and C<jats:sub>rs<\/jats:sub> were significantly associated with the normally aerated lung volume. This research underscores the significance of C<jats:sub>rs<\/jats:sub> at the applied PEEP as a bedside-measurable parameter and sheds new light on the link between recruitability and normally aerated lung.<\/jats:p>","DOI":"10.1038\/s41598-024-64622-3","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T11:03:19Z","timestamp":1719226999000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Correlation between normally aerated lung and respiratory system compliance at clinical high positive end-expiratory pressure in patients with COVID-19"],"prefix":"10.1038","volume":"14","author":[{"given":"Keishi","family":"Ogura","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuichi","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naofumi","family":"Bunya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinshu","family":"Katayama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoya","family":"Yama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuya","family":"Goto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keigo","family":"Sawamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuji","family":"Uemura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eichi","family":"Narimatsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"64622_CR1","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1007\/s00134-015-4200-8","volume":"42","author":"L Gattinoni","year":"2016","unstructured":"Gattinoni, L. et al. 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The other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"14477"}}