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Novel Approach to Identifying Impaired Intraoperative Lung Mechanics

Award Number: F32HL184607
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 03/01/2027
PERIOD OF PERFORMANCE END DATE: 02/29/2028

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Novel Approach to Identifying Impaired Intraoperative Lung Mechanics - PROJECT SUMMARY Mechanical ventilation during surgery can injure the lungs despite use of standard Lung Protective Ventilation strategies. Current methods for monitoring intraoperative lung function are not sensitive enough to detect emerging injury that may lead to postoperative pulmonary complications. As over 15 million surgeries require mechanical ventilation each year, a safe and sensitive method for detecting lung injury from mechanical ventilation is an urgent need in anesthesiology. Surgical conditions predispose a patient's lung to collapse, a process known as de-recruitment. Stressful surgical positioning like Trendelenburg—a 30° head-down positioning—can adversely affect the mechanical properties of the lung. Obesity affects 40% of American adults and alters lung mechanics, which doubles the risk for postoperative pulmonary complications. Our prior studies show that body mass index (BMI) is a prime determinant of lung mechanical impairment during surgery, leading to a mix of persistent and dynamic de-recruitment, which Trendelenburg exacerbates. These data indicated two major causes of de-recruitment in patients with obesity: individual variability in pulmonary mechanics, and insufficient positive end-expiratory pressure (PEEP) to keep airways and alveoli open. Optimizing PEEP can avoid the pressure at which the lung collapses, known as a “tipping point”, but there is no consensus on individualizing PEEP. Electrical impedance tomography (EIT) is a clinical tool for real-time visualization of lung de-recruitment and overdistention. Selecting PEEP to minimize de-recruitment and overdistention is difficult without knowing its effects on pulmonary mechanics. Accordingly, we built a custom device to measure pulmonary mechanics during surgical mechanical ventilation by applying a method known as oscillometry. Our overall objective is to integrate oscillometry and EIT to gain a comprehensive composite picture of real-time regional lung mechanics in ventilated patients with obesity. Our overarching hypothesis is that obesity and Trendelenburg induce unstable pressure conditions that impair lung function through individualized and heterogeneous patterns of de-recruitment. To test this hypothesis, we will determine effect of obesity and Trendelenburg on regional lung mechanics (Aim 1) and then determine how adjusting PEEP in Trendelenburg affects regional lung mechanics (Aim 2). Using cutting-edge mechanical analyses and real-time ventilation imaging, we expect to find that obesity and Trendelenburg impair lung mechanics in a spatially heterogeneous manner, and that optimal PEEP values increase with BMI and stressful surgical positioning. This will significantly improve our understanding of how obesity and Trendelenburg affect lung function, informing future interventional studies and providing a clinically deployable tool for physiological lung monitoring during mechanical ventilation. This work will be paired with a training plan featuring didactic learning, professional development, and mentorship from clinician-scientists at an R1 institution with an established translational research program, providing a solid foundation for an independent biomedical career.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $82,348 )
2026	2026	UNIVERSITY OF VERMONT & STATE AGRICULTURAL COLLEGE	85 S PROSPECT STREET	BURLINGTON	VT	05405	CHITTENDEN	USA	Lung Diseases Research	000	1	9/7/2026	NEW	$82,348
														Subtotal = $82,348

Grand Total All Awards = $82,348

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Novel Approach to Identifying Impaired Intraoperative Lung Mechanics

Award Number: F32HL184607

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 03/01/2027

PERIOD OF PERFORMANCE END DATE: 02/29/2028

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