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  • Barotrauma  (1)
  • Elastic recoil  (1)
  • 1
    ISSN: 1432-1238
    Keywords: Key words Animal ; Porcine ; Mechanics ; Compliance ; Elastic recoil ; Recruitment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To study pressure-volume (P/V) curves over a wide pressure and volume range in pigs.¶Design: Dynamic and static P/V curves (Pdyn/V and Pst/V) and compliance of the respiratory system were studied. The effects of recruitment, positive end-expiratory pressure (PEEP) and body position were analysed.¶Setting: Research animal laboratory.¶Materials: Seven anaesthetised, paralysed and ventilated healthy pigs of 21 kg.¶Measurements: P/V curves up to a pressure of about 40 cmH2O were recorded with a computer-controlled ventilator. Pst/V curves were obtained with the static occlusion method and Pdyn/V curves during an insufflation at a low, constant flow rate.¶Results: Pdyn/V recording showed a complex pattern. During the insufflation compliance increased, fell, increased and fell again. A 2nd ¶Pdyn/V recording immediately following the 1st one was displaced towards higher volumes and showed only one maximum of compliance. The difference between the two curves reflected: (1) lung collapse during a period of 5 min of ventilation at zero end-expiratory pressure (ZEEP) following a recruitment manoeuvre, (2) recruitment during the measurement of the 1st Pdyn/V curve. These observations were similar in the supine and in the left lateral position. After ventilation at PEEP, 4 cmH2O, the signs of collapse and recruitment were reduced. It was confirmed that PEEP offers a partial protection against collapse. Pst/V curves showed higher volumes and higher compliance values compared to Pdyn/V curves. This reflects the influence of viscoelastance on Pdyn/V curves.¶Conclusion: The study demonstrates a particularly strong tendency to lung collapse in pigs.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 25 (1999), S. 674-679 
    ISSN: 1432-1238
    Keywords: Key words Mechanical ventilation ; Dead space ; Airway pressure ; Barotrauma ; Tracheal gas insufflation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Aspiration of dead space (ASPIDS) improves carbon dioxide (CO2) elimination by replacing dead space air rich in CO2 with fresh gas during expiration. The hypothesis was that ASPIDS allows normocapnia to be maintained at low tidal volumes (VT). Design: Prospective study. Setting: Adult intensive care unit in a university hospital. Patients: Seven patients ventilated for neurological reasons were studied. All patients were clinically and haemodynamically stable and monitored according to clinical needs. Interventions: ASPIDS implies that, during expiration, gas is aspirated through a catheter inserted in the tracheal tube. Simultaneously, a compensatory flow of fresh gas is injected into the inspiratory line. ASPIDS was achieved with a computer/ventilator system controlling two solenoid valves for aspiration and injection. Results: At the basal respiratory rate of 12.6 breaths min–1, with ASPIDS VT decreased from 602 to 456 ml, as did the airway pressures to a corresponding degree. PaCO2 and PaO2 remained stable. At a frequency of 20 breaths min–1, with ASPIDS VT was further reduced to 305 ml with preserved normocapnia. ASPIDS did not interfere with the positive end-expiratory pressure (PEEP) level. No intrinsic PEEP developed. All patients remained stable. No haemodynamic or other side effects of ASPIDS were noticed. Conclusion: The results of this study suggest that ASPIDS may be a useful and safe modality of mechanical ventilation that limits alveolar pressure and minute ventilation requirements while keeping PaCO2 constant.
    Type of Medium: Electronic Resource
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