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(Chest. 1998;113:1667-1672.)
© 1998 American College of Chest Physicians

Respiratory Mechanics After Prosthetic Reconstruction of the Chest Wall in Normal Rats

Amarílio V. Macedo-Neto MD, PhD1; Leonardo V. Santos MD1; Sara L.S. Menezes MSc1; Daniela S.S. Paiva MD1; Patricia R.M. Rocco MD, PhD1; and Walter A. Zin MD, PhD1

1 From the Laboratory of Respiration Physiology, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Brazil

Objective: Prosthetic reconstruction of the chest wall may yield several respiratory changes. Nevertheless, to our knowledge, no comprehensive analysis of respiratory mechanics under this condition has been hitherto performed.

Methods: Respiratory mechanics were evaluated in two groups of rats. In one group (n=8), a polytetrafluoroethylene (PTFE) patch was used; in another group (n=8), a polypropylene mesh (Marlex) associated with methylmethacrylate (PPMM) was employed. All animals were sedated, anesthetized, paralyzed, and mechanically ventilated before and after the prosthetic reconstruction of the chest wall. After airway occlusion at end inspiration, respiratory system, pulmonary, and chest wall resistive pressures (DgrP1rs, DgrP1L, and DgrP1CW, respectively) and viscoelastic/inhomogenous pressures (DgrP2rs, DgrP2L, and DgrP2cw, respectively) were determined. Respiratory system, lung, and chest wall static (Estrs, EstL, and Estcw, respectively), and dynamic elastances (Edynrs, EdynL, and Edyncw, respectively), and the corresponding Dgr elastances (DgrE, calculated as Edyn-Est) were also obtained.

Results: In both groups, significant increases in DgrP2rs, DgrP2cw, DgrErs, DgrEcw, Estrs, EstL, and Estcw were observed after chest wall reconstruction. However, DgrP2rs, DgrP2cw, DgrErs, DgrEcw, Estrs, and EstL were significantly higher in the PPMM group than in the PTFE group.

Conclusions: Prosthetic reconstruction of the chest wall yields not only elastic changes, but also there is also an important increase of pressure dissipated against viscoelastic/inhomogenous segments of the chest wall. Furthermore, taking into account respiratory mechanics, the PTFE patch might be preferred to the PPMM patch.

Key Words: chest wall • elastance • mechanical inhomogeneities • prosthesis • viscoelasticity

Submitted on June 27, 1997
Accepted on October 3, 1997




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S. L.S. Menezes, P. S.C. Chagas, A. V. Macedo-Neto, V. C.T. Santos, P. R.M. Rocco, and W. A. Zin
Suture or Prosthetic Reconstruction of Experimental Diaphragmatic Defects
Chest, May 1, 2000; 117(5): 1443 - 1448.
[Abstract] [Full Text] [PDF]


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