Browsing by Author "Pérez, Agustín"

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    A machine-learning regional clustering approach to understand ventilator-induced lung injury: a proof-of-concept experimental study
    (2024) Cruces, Pablo; Retamal, Jaime; Damián, Andrés; Lago, Graciela; Blasina, Fernanda; Oviedo, Vanessa; Medina, Tania; Pérez, Agustín; Vaamonde, Lucía; Dapueto, Rosina; González-Dambrauskas, Sebastian; Serra, Alberto; Monteverde-Fernandez, Nicolas; Namías, Mauro; Martínez, Javier; Hurtado, Daniel E.
    Background The spatiotemporal progression and patterns of tissue deformation in ventilator-induced lung injury (VILI) remain understudied. Our aim was to identify lung clusters based on their regional mechanical behavior over space and time in lungs subjected to VILI using machine-learning techniques. Results Ten anesthetized pigs (27±2 kg) were studied. Eight subjects were analyzed. End-inspiratory and endexpiratory lung computed tomography scans were performed at the beginning and after 12 h of one-hit VILI model. Regional image-based biomechanical analysis was used to determine end-expiratory aeration, tidal recruitment, and volumetric strain for both early and late stages. Clustering analysis was performed using principal component analysis and K-Means algorithms. We identifed three diferent clusters of lung tissue: Stable, Recruitable Unstable, and Non-Recruitable Unstable. End-expiratory aeration, tidal recruitment, and volumetric strain were signifcantly diferent between clusters at early stage. At late stage, we found a step loss of end-expiratory aeration among clusters, lowest in Stable, followed by Unstable Recruitable, and highest in the Unstable Non-Recruitable cluster. Volumetric strain remaining unchanged in the Stable cluster, with slight increases in the Recruitable cluster, and strong reduction in the Unstable Non-Recruitable cluster. Conclusions VILI is a regional and dynamic phenomenon. Using unbiased machine-learning techniques we can identify the coexistence of three functional lung tissue compartments with diferent spatiotemporal regional biomechanical behavior.
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    Noninvasive Continuous Positive Airway Pressure Is a Lung- and Diaphragm-protective Approach in Self-inflicted Lung Injury
    (2024) Cruces, Pablo; Erranz, Benjamín; Pérez, Agustín; Reveco, Sonia; González, Carlos; Retamal, Jaime; Poblete Navarro, Daniela Andrea; Hurtado, Daniel E.; Diaz, Franco