{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T13:58:51Z","timestamp":1775483931522,"version":"3.50.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p><jats:bold>Background<\/jats:bold>. Global and regional transpulmonary pressure (P<jats:sub>L<\/jats:sub>) during one-lung ventilation (OLV) is poorly characterized. We hypothesized that global and regional P<jats:sub>L<\/jats:sub> and driving P<jats:sub>L<\/jats:sub> (\u0394P<jats:sub>L<\/jats:sub>) increase during protective low tidal volume OLV compared to two-lung ventilation (TLV), and vary with body position.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>. In sixteen anesthetized juvenile pigs, intra-pleural pressure sensors were placed in ventral, dorsal, and caudal zones of the left hemithorax by video-assisted thoracoscopy. A right thoracotomy was performed and lipopolysaccharide administered intravenously to mimic the inflammatory response due to thoracic surgery. Animals were ventilated in a volume-controlled mode with a tidal volume (V<jats:sub>T<\/jats:sub>) of 6\u00a0mL\u00a0kg<jats:sup>\u22121<\/jats:sup> during TLV and of 5\u00a0mL\u00a0kg<jats:sup>\u22121<\/jats:sup> during OLV and a positive end-expiratory pressure (PEEP) of 5 cmH<jats:sub>2<\/jats:sub>O. Global and local transpulmonary pressures were calculated. Lung instability was defined as end-expiratory P<jats:sub>L<\/jats:sub>&amp;lt;2.9 cmH<jats:sub>2<\/jats:sub>O according to previous investigations. Variables were acquired during TLV (TLVsupine), left lung ventilation in supine (OLVsupine), semilateral (OLVsemilateral), lateral (OLVlateral) and prone (OLVprone) positions randomized according to Latin-square sequence. Effects of position were tested using repeated measures ANOVA.<\/jats:p><jats:p><jats:bold>Results<\/jats:bold>. End-expiratory P<jats:sub>L<\/jats:sub> and \u0394P<jats:sub>L<\/jats:sub> were higher during OLVsupine than TLVsupine. During OLV, regional end-inspiratory P<jats:sub>L<\/jats:sub> and \u0394P<jats:sub>L<\/jats:sub> did not differ significantly among body positions. Yet, end-expiratory P<jats:sub>L<\/jats:sub> was lower in semilateral (ventral: 4.8 \u00b1 2.9 cmH<jats:sub>2<\/jats:sub>O; caudal: 3.1 \u00b1 2.6 cmH<jats:sub>2<\/jats:sub>O) and lateral (ventral: 1.9 \u00b1 3.3 cmH<jats:sub>2<\/jats:sub>O; caudal: 2.7 \u00b1 1.7 cmH<jats:sub>2<\/jats:sub>O) compared to supine (ventral: 4.8 \u00b1 2.9 cmH<jats:sub>2<\/jats:sub>O; caudal: 3.1 \u00b1 2.6 cmH<jats:sub>2<\/jats:sub>O) and prone position (ventral: 1.7 \u00b1 2.5 cmH<jats:sub>2<\/jats:sub>O; caudal: 3.3 \u00b1 1.6 cmH<jats:sub>2<\/jats:sub>O), mainly in ventral (<jats:italic>p<\/jats:italic> \u2264 0.001) and caudal (<jats:italic>p<\/jats:italic> = 0.007) regions. Lung instability was detected more often in semilateral (26 out of 48 measurements; <jats:italic>p<\/jats:italic> = 0.012) and lateral (29 out of 48 measurements, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) as compared to supine position (15 out of 48 measurements), and more often in lateral as compared to prone position (19 out of 48 measurements, <jats:italic>p<\/jats:italic> = 0.027).<\/jats:p><jats:p><jats:bold>Conclusion<\/jats:bold>. Compared to TLV, OLV increased lung stress. Body position did not affect stress of the ventilated lung during OLV, but lung stability was lowest in semilateral and lateral decubitus position.<\/jats:p>","DOI":"10.3389\/fphys.2023.1204531","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T08:09:55Z","timestamp":1691136595000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Distribution of transpulmonary pressure during one-lung ventilation in pigs at different body positions"],"prefix":"10.3389","volume":"14","author":[{"given":"Jakob","family":"Wittenstein","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Scharffenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiuli","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Bluth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Kiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus J.","family":"Schultz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia R. 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