Dr. Perlman's Lung Mechanics Laboratory is developing new mechanical and pharmacological means of reducing ventilation injury of edematous lungs.
In a condition known as acute respiratory distress syndrome (ARDS), inflammation causes liquid to leak out of the pulmonary blood vessels into the alveoli, the smallest airspaces of the lungs. Such liquid-flooding of alveoli makes breathing difficult. Thus ARDS patients are treated with mechanical ventilation, which assists breathing. Mechanical ventilation, however, often causes an additional over-distension injury of the lungs – ventilation induced lung injury (VILI) – that can prevent recovery. The mortality rate for ARDS/VILI exceeds 35%.
We study the micromechanics of flooded alveoli in the lungs. We identified anatomical sites of stress concentration that are likely sites of VILI. We showed that the degree of stress concentration is proportional to the surface tension at the air-liquid interface in flooded alveoli. Subsequently, we developed the first means of determining surface tension in flooded alveoli of the lungs. With this new method, we identified compounds that, through a novel mechanism, lower surface tension in the lungs. We are testing the compounds for the ability to reduce VILI and improve survival in ARDS.
- Pulmonary physiology
- Surfactant biophysics