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  • 1
    ISSN: 1432-1238
    Keywords: Respiratory mechanics ; Respiratory resistance ; Respiratory compliance ; Mechanical ventilation ; Pressure support ventilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate a least squares fitting technique for the purpose of measuring total respiratory compliance (Crs) and resistance (Rrs) in patients submitted to partial ventilatory support, without the need for esophageal pressure measurement. Design Prospective, randomized study. Setting A general ICU of a University Hospital. Patients 11 patients in acute respiratory failure, intubated and assisted by pressure support ventilation (PSV). Interventions Patients were ventilated at 4 different levels of pressure support. At the end of the study, they were paralyzed for diagnostic reasons and submitted to volume controlled ventilation (CMV). Measurements and results A least squares fitting (LSF) method was applied to measure Crs and Rrs at different levels of pressure support as well as in CMV. Crs and Rrs calculated by the LSF method were compared to reference values which were obtained in PSV by measurement of esophageal pressure, and in CMV by the application of the constant flow, end-inspiratory occlusion method. Inspiratory activity was measured by P0.1. In CMV, Crs and Rrs measured by the LSF method are close to quasistatic compliance (−1.5±1.5 ml/cmH2O) and to the mean value of minimum and maximum end-inspiratory resistance (+0.9±2.5 cmH2O/(l/s)). Applied during PSV, the LSF method leads to gross underestimation of Rrs (−10.4±2.3 cmH2O/(l/s)) and overestimation of Crs (+35.2±33 ml/cmH2O) whenever the set pressure support level is low and the activity of the respiratory muscles is high (P0.1 was 4.6±3.1 cmH2O). However, satisfactory estimations of Crs and Rrs by the LSF method were obtained at increased pressure support levels, resulting in a mean error of −0.4±6 ml/cmH2O and −2.8±1.5 cmH2O/(l/s), respectively. This condition was coincident with a P0.1 of 1.6±0.7 cmH2O. Conclusion The LSF method allows non-invasive evaluation of respiratory mechanics during PSV, provided that a near-relaxation condition is obtained by means of an adequately increased pressure support level. The measurement of P0.1 may be helpful for titrating the pressure support in order to obtain the condition of near-relaxation.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Key words Respiration ; artificial instrumentation ; Heat and moisture exchanger ; Respiratory mechanics ; Pressure support ventilation ; P0.1 ; Feedback control
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To investigate the mechanical effects of artificial noses. Setting: A general intensive care unit of a university hospital. Patients: 10 patients in pressure support ventilation for acute respir
    Type of Medium: Electronic Resource
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