Fig. 3

Hemodynamics. Pink lines and dots represent animals from the pneumonia-with-VILI group, and the green ones represent those animals from pneumonia-without-VILI group. A The evolution of VDI showed the need to use norepinephrine to maintain mean arterial pressure in the group of pigs with VILI and in those pigs ventilated protectively. B Mean pulmonary pressure increased at pneumonia diagnosis and remained stable in the pneumonia-with-VILI group, whereas it decreased in the group without VILI. C, D CVP and PAOP did not present significant differences between groups. E, F A higher cardiac output and heart rate were found in animals with VILI in comparison with those ventilated protectively. G Animals developing ARDS presented higher maximal left ventricular pressure rise (LV dPmax) as a marker of systolic function. H Systemic vascular resistance decreased in animals with pneumonia and VILI in comparison with the group of pigs without VILI. Abbreviations: ARDS: acute respiratory distress syndrome; CVP: central venous pressure; LV dPmax: maximal left ventricle pressure rise; MAP: mean arterial pressure; PAOP: pulmonary arterial occlusion pressure; VDI: vasopressor dependency index. Data are reported as mean ± standard error of mean (SEM). # ARDS diagnosis time point in the pneumonia-without-VILI group corresponds to 30 h from inoculum, which is the median time from inoculum to ARDS diagnosis in the pneumonia-with-VILI group. This equivalence needed to be done for comparison reasons because the pneumonia-without-VILI group never met the Berlin criteria for ARDS diagnosis. *p < 0.05