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Titolo:
PRESSURE-VOLUME CURVES IN ACUTE RESPIRATORY-FAILURE - AUTOMATED LOW-FLOW INFLATION VERSUS OCCLUSION
Autore:
SERVILLO G; SVANTESSON C; BEYDON L; ROUPIE E; BROCHARD L; LEMAIRE F; JONSON B;
Indirizzi:
UNIV LUND HOSP,DEPT CLIN PHYSIOL S-22185 LUND SWEDEN UNIV LUND HOSP,DEPT CLIN PHYSIOL S-22185 LUND SWEDEN UNIV PARIS 12,HOP HENRI MONDOR,INSERM U296,MED INTENS CARE UNIT F-94010 CRETEIL FRANCE UNIV PARIS 12,HOP HENRI MONDOR,INSERM U296,SURG INTENS CARE UNIT F-94010 CRETEIL FRANCE
Titolo Testata:
American journal of respiratory and critical care medicine
fascicolo: 5, volume: 155, anno: 1997,
pagine: 1629 - 1636
SICI:
1073-449X(1997)155:5<1629:PCIAR->2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
END-EXPIRATORY PRESSURE; DISTRESS SYNDROME; MECHANICAL VENTILATION; TIDAL VOLUME; ARTIFICIAL-VENTILATION; AIRWAY PRESSURE; PULMONARY-EDEMA; SHORT PERIODS; CHEST-WALL; SYSTEM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
35
Recensione:
Indirizzi per estratti:
Citazione:
G. Servillo et al., "PRESSURE-VOLUME CURVES IN ACUTE RESPIRATORY-FAILURE - AUTOMATED LOW-FLOW INFLATION VERSUS OCCLUSION", American journal of respiratory and critical care medicine, 155(5), 1997, pp. 1629-1636

Abstract

Pressure-volume (P-V) curves of the respiratory system allow determination of compliance and lower and upper inflection points (LIP and UIP, respectively). To minimize lung trauma in mechanical ventilation thetidal volume should be limited to the P-V range between LIP and UIP. An automated low flow inflation (ALFI) technique, using a computer-controlled Servo Ventilator 900C, was compared with a more conventional technique using a series of about 20 different inflated volumes (Pst-V curve). The pressure in the distal lung (Pdist) was calculated by subtraction of resistive pressure drop in connecting tubes and airways. Compliance (Cdist), Pdist(LIP) and Pdist(UIP) were derived from the Pdist-V curve and compared with Cst, PsSt(LIP), and Pst(UIP) derived from the Pst-V curve. Nineteen sedated, paralyzed patients (10 with ARDS and 9 with ARF) were studied. We found: Cdist = 2.3 + 0.98 . Cst ml/cm H2O (r = 0.98); Pdist(LIP) = 0.013 + 1.09 . Pst(LIP) cm H2O (r = 0.96). In patients with ARDS: Pdist(LIP) = 4.71 + 0.84 Pst(UIP) cm H2O (r = 0.94). In ARF, we found differences in UIP between the methods, but discrepancies occurred above tidal volumes and had little practical importance. They may reflect that Pdist comprises dynamic phenomena contributing to pressure in the distal lung at large volumes. Compliance, but not LIP and UIP, could be accurately determined without subtraction of resistive pressure from the pressure measured in the ventilator. Weconclude that ALFI, which is fully automated and needing no ventilator disconnection, gives useful clinical information.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 06:27:10