Estimation of Inspiratory Respiratory Elastance Using Expiratory Data

التفاصيل البيبلوغرافية
العنوان: Estimation of Inspiratory Respiratory Elastance Using Expiratory Data
المؤلفون: Howe, S. L., Chase, J. G., Redmond, D. P., Morton, S. E., Kim, K. T., Pretty, C., Shaw, G. M., Tawhai, M. H., Desaive, Thomas
المصدر: IFAC-PapersOnLine, 51 (27), 204-208 (2018); BMS 2018, 3-5 septembre 2018
بيانات النشر: Elsevier B.V., 2018.
سنة النشر: 2018
مصطلحات موضوعية: Lungs, Mathematical models, Mechanical ventilation, Parameter identification, Respiratory elastance, Biological organs, Estimation, Identification (control systems), Respiratory mechanics, Ventilation, Conventional methods, Elastance, Linear relationships, Models of Respiratory Mechanics, Muscle activities, Spontaneous breathing, Patient treatment, Human health sciences, Anesthesia & intensive care, Sciences de la santé humaine, Anesthésie & soins intensifs
الوصف: Models of respiratory mechanics can be used to titrate patient-specific mechanical ventilation (MV) settings in critical care, but often perform poorly in the presence of patient breathing effort. Respiratory mechanics are conventionally calculated using only inspiratory data. Muscle activity is normally assumed relatively minimal or absent during passive expiration regardless of the presence of inspiratory spontaneous breathing (SB) efforts. Hence, this study assesses whether expiratory lung elastance can be used to estimate inspiratory lung elastance for spontaneously breathing, reverse triggered patients. Clinical data from recruitment manoeuvres in fully sedated patients were used to determine a relationship between inspiratory and expiratory modeled lung elastance. The validity of this relationship was assessed using data recorded pre- and post- sedation from different patients. A strong, linear relationship was found between inspiratory and expiratory elastance in fully sedated patients, with gradient 1.04 [95% CI: 1.03-1.07] and intercept 1.66 [1.06-2.08] with R2 = 0.94. After adjustment according to the linear relationship, expiratory elastance produced stable estimations post sedation, with similar median and variance as inspiratory elastance. However, variation in estimates pre-sedation, although significantly improved, may be larger than clinically acceptable in some cases. The results of this study show that the typically ignored expiratory data may be able to provide insight into patient condition when conventional methods fail. Clinically, these methods could have an impact in guiding MV therapy by providing clinicians with information about lung mechanics under the effect of patient SB effort. © 2018
نوع الوثيقة: conference paper
http://purl.org/coar/resource_type/c_5794Test
conferenceObject
peer reviewed
اللغة: English
العلاقة: urn:issn:2405-8971; urn:issn:2405-8963
DOI: 10.1016/j.ifacol.2018.11.642
الوصول الحر: https://orbi.uliege.be/handle/2268/248133Test
حقوق: open access
http://purl.org/coar/access_right/c_abf2Test
info:eu-repo/semantics/openAccess
رقم الانضمام: edsorb.248133
قاعدة البيانات: ORBi