Alveolar pressure monitoring: an evaluation in a lung model and in patients with acute lung injury

2.50
Hdl Handle:
http://hdl.handle.net/2336/15734
Title:
Alveolar pressure monitoring: an evaluation in a lung model and in patients with acute lung injury
Authors:
Sondergaard, S; Karason, S; Wiklund, J; Lundin, S; Stenqvist, O
Citation:
Intensive Care Med. 2003, 29(6):955-62
Issue Date:
1-Jun-2003
Abstract:
OBJECTIVES: We evaluated an algorithm for continuous on-line monitoring of alveolar pressure over time in a lung model with lower and upper inflection points and variable resistance ratios and in patients with acute lung injury. The algorithm is based on "static" pressure/volume curves obtained from tracheal pressure measurements under dynamic conditions. DESIGN AND SETTING: Experimental and clinical evaluation of algorithm in a university hospital laboratory and intensive care unit. PATIENTS: Ten patients undergoing postoperative respiratory therapy (feasibility of tracheal measurement) and ten patients with acute lung injury undergoing ventilator treatment (evaluation of algorithm). MEASUREMENTS AND RESULTS: Direct tracheal pressure measurements with a catheter inserted through the endotracheal tube. Comparison of measured alveolar and the dynostatic alveolar pressure vs. time in a lung model with changes in five ventilatory parameters. Examples of clinical monitoring are reported. In the model there was excellent agreement between alveolar pressures obtained by the algorithm, the dynostatic alveolar pressure, and measured alveolar pressure at all ventilator settings. For inspiratory/expiratory resistance ratios between 1:2.1-2.1:1, the dynostatic alveolar pressure was within +/-1.5 cm H(2)O of measured alveolar pressure. In patients the technique for direct tracheal pressure measurement using a catheter inserted through the endotracheal tube functioned satisfactorily with intermittent air flushes for cleansing. CONCLUSIONS: Using a thin tracheal pressure catheter inserted through the endotracheal tube alveolar pressure allows continuous bedside monitoring with ease and precision using the dynostatic algorithm. The method is unaffected by tube and connector geometry or by secretions.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://www.springerlink.com/content/95emgpaqjybgvf5y

Full metadata record

DC FieldValue Language
dc.contributor.authorSondergaard, S-
dc.contributor.authorKarason, S-
dc.contributor.authorWiklund, J-
dc.contributor.authorLundin, S-
dc.contributor.authorStenqvist, O-
dc.date.accessioned2008-01-07T10:50:10Z-
dc.date.available2008-01-07T10:50:10Z-
dc.date.issued2003-06-01-
dc.date.submitted2007-01-07-
dc.identifier.citationIntensive Care Med. 2003, 29(6):955-62en
dc.identifier.issn0342-4642-
dc.identifier.pmid12690438-
dc.identifier.doi10.1007/s00134-003-1730-2-
dc.identifier.urihttp://hdl.handle.net/2336/15734-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractOBJECTIVES: We evaluated an algorithm for continuous on-line monitoring of alveolar pressure over time in a lung model with lower and upper inflection points and variable resistance ratios and in patients with acute lung injury. The algorithm is based on "static" pressure/volume curves obtained from tracheal pressure measurements under dynamic conditions. DESIGN AND SETTING: Experimental and clinical evaluation of algorithm in a university hospital laboratory and intensive care unit. PATIENTS: Ten patients undergoing postoperative respiratory therapy (feasibility of tracheal measurement) and ten patients with acute lung injury undergoing ventilator treatment (evaluation of algorithm). MEASUREMENTS AND RESULTS: Direct tracheal pressure measurements with a catheter inserted through the endotracheal tube. Comparison of measured alveolar and the dynostatic alveolar pressure vs. time in a lung model with changes in five ventilatory parameters. Examples of clinical monitoring are reported. In the model there was excellent agreement between alveolar pressures obtained by the algorithm, the dynostatic alveolar pressure, and measured alveolar pressure at all ventilator settings. For inspiratory/expiratory resistance ratios between 1:2.1-2.1:1, the dynostatic alveolar pressure was within +/-1.5 cm H(2)O of measured alveolar pressure. In patients the technique for direct tracheal pressure measurement using a catheter inserted through the endotracheal tube functioned satisfactorily with intermittent air flushes for cleansing. CONCLUSIONS: Using a thin tracheal pressure catheter inserted through the endotracheal tube alveolar pressure allows continuous bedside monitoring with ease and precision using the dynostatic algorithm. The method is unaffected by tube and connector geometry or by secretions.en
dc.language.isoenen
dc.publisherSpringer Verlagen
dc.relation.urlhttp://www.springerlink.com/content/95emgpaqjybgvf5yen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshAirway Resistanceen
dc.subject.meshAlgorithmsen
dc.subject.meshFeasibility Studiesen
dc.subject.meshHumansen
dc.subject.meshIntubation, Intratrachealen
dc.subject.meshLung Complianceen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshModels, Biologicalen
dc.subject.meshMonitoring, Physiologicen
dc.subject.meshPositive-Pressure Respirationen
dc.subject.meshPressureen
dc.subject.meshPulmonary Alveolien
dc.subject.meshPulmonary Wedge Pressureen
dc.subject.meshRespiratory Distress Syndrome, Adulten
dc.subject.meshRespiratory Mechanicsen
dc.subject.meshTidal Volumeen
dc.subject.meshTracheaen
dc.titleAlveolar pressure monitoring: an evaluation in a lung model and in patients with acute lung injuryen
dc.typeArticleen
dc.contributor.departmentDepartment of Anaesthesia and Intensive Care, Landspitali University Hospital, Reykjavik, Icelanden

Related articles on PubMed

All Items in Hirsla are protected by copyright, with all rights reserved, unless otherwise indicated.