Video with the in vivo microscope of normal subpleural alveoli during tidal ventilation. Note alveoli change size very little in normal alveoli from peak inspiration to end-expiration.
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In vivo microscopic video following Tween endotracheal lavage for surfactant deactivation prior to the recruitment maneuver, and we see dense atelectasis with no patent alveoli visible. As the recruitment maneuver proceeds (Peak pressure 45cm H2O, PEEP 35cm H2O sustained for 1 minute), we see alveoli recruit open and continue to recruit as late as 45 seconds into the maneuver.
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In vivo video of subpleural alveoli ventilated with the lower PEEP setting of 5cm H2O following Tween lavage and recruitment maneuver, which demonstrates significant change in size from peak inspiration to end-expiration, with several alveoli in the center of the field undergoing total recruitment/derecruitment with tidal ventilation.
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Video with the in vivo microscope of alveoli ventilated with the higher PEEP setting of 10cm H2O following Tween lavage and recruitment maneuver, in which alveoli change size very little from peak inspiration to end-expiration, in contrast to Video E3 with the lower PEEP of 5cm H2O. This stable alveolar behavior resembles that seen in the normal alveoli prior to surfactant deactivation (Video E1).
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