Evaluation of Respiratory Inductive Plethysmography in Controlled Ventilation
| Autor: | J. Zinserling, Michael Sydow, Hilmar Burchardi, Peter J. Neumann, Christian Haase |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Pulmonary and Respiratory Medicine
Mechanical ventilation business.industry medicine.medical_treatment 030208 emergency & critical care medicine Lung injury Critical Care and Intensive Care Medicine Nitrogen washout respiratory tract diseases Pulmonary function testing 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Anesthesia medicine Breathing Lung volumes Cardiology and Cardiovascular Medicine business Positive end-expiratory pressure Tidal volume |
| Zdroj: | Chest. 113:443-451 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.113.2.443 |
| Popis: | Study objective To determine the accuracy of respiratory inductive plethysmography (RIP) with a respiratory monitor (Respitrace Plus; NIMS Inc., Miami) operating in the DC-mode for the measurement of tidal volumes (Vt) and positive end-expiratory pressure (PEEP)-induced changes of end-expiratory lung volume (ΔEELV) in patients with normal pulmonary function, acute lung injury (ALI), and COPD during volume-controlled ventilation. Design Prospective comparison of RIP with pneumotachography (PT) for assessment of Vt and with multibreath nitrogen washout procedure (N 2 WO) for determination of ΔEELV as reference methods. Setting Mixed ICU at a university hospital. Patients Thirty-one sedated and paralyzed patients: 12 patients with normal pulmonary function mechanically ventilated after major surgery, 10 patients with respiratory failure due to ALI, and 9 patients with a known history of COPD ventilated after surgery or because of respiratory failure due to bronchopulmonary infection. Interventions Stepwise increase of PEEP from 0 to 5 to 10 cm H 2 O and reduction to 0 cm H 2 O again. On each PEEP level, N 2 WO was performed. Measurements and main results The baseline drift of RIP averaged 25.4±29.1 mL/min but changed over a wide range even in single patient measurements. Determination of Vt for single minutes revealed that 66.5% and 90.0% of all values were accurate within a range of±10% and±20%, respectively. The deviation for Vt measurements between RIP and PT in patients with COPD was significantly (p 2 WO was 11.6±174.1 mL with correlation coefficients of 0.77 (postoperative and COPD patients) and 0.86 (ALI patients). However, just 25.8% and 46.2% were precise within±10% and±20%, respectively. ΔEELV determination in COPD patients differed more between RIP and N 2 WO than in the other groups, but this was not significant. Conclusion In a mixed group of patients undergoing controlled ventilation, RIP using the Respitrace Plus monitor was not consistently precise enough for quantitative evaluation of Vt and EELV when compared to our reference methods. This was most evident in patients with COPD. For long-term volume measurements, a better control of the baseline drift of RIP should be achieved. |
| Databáze: | OpenAIRE |
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