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End Expiratory Pressure (end + expiratory_pressure)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of End Expiratory Pressure

  • positive end expiratory pressure
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    Selected Abstracts

    Validation and clinical feasibility of nitrogen washin/washout functional residual capacity measurements in children

    ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2010
    C. OLEGÅRD
    Background: The functional residual capacity (FRC) is an important parameter in pediatric respiratory monitoring but it is difficult to assess in the clinical setting. We have introduced a modified N2 washout method utilizing a change of FIO2 of 0.1 for FRC measurement in adult respiratory monitoring. This study validated the algorithm in a pediatric lung model and investigated the stability and feasibility in a pediatric peri-operative and intensive care setting. Methods: The lung model was ventilated in combinations of ventilatory modes, CO2 production, model FRC and respiratory rates. Sixteen children from 10 days to 5 years were studied peri-operatively with controlled ventilation using a Mapleson D system and in the intensive care unit using a Servo-i ventilator in a supported spontaneous mode. FRC was measured during stable metabolic, respiratory and circulatory periods at positive end expiratory pressure of 3,4 and 7,8 cmH2O. Results: In the model and in the clinical setting, we found an excellent agreement between washout and washin measurements of FRC as well as acceptable coefficients of repeatability. Conclusion: FRC was satisfactorily measured by a modified N2 algorithm and may be included as a monitoring variable in pediatric respiratory care. Pediatric FRC monitoring demands strictly stable conditions as measurements are performed close to the limits of the monitor's specifications. [source]

    Suggested Strategies for Ventilatory Management of Veterinary Patients with Acute Respiratory Distress Syndrome

    JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2001
    Erika R. Mueller DVM
    Abstract Objective: To review the current recommendations and guidelines for mechanical ventilation in humans and in animals with acute respiratory distress syndrome. Human data synthesis: Acute respiratory distress syndrome (ARDS) in humans in defined as an acute onset of bilateral, diffuse infiltrates on thoracic radiographs that are not the result of heart disease and a significant oxygenation impairment. These patients require mechanical ventilation. Research has shown that further pulmonary damage can occur as a result of mechanical ventilation. Various alveolar recruitment maneuvers and a low tidal volume with increased positive end expiratory pressure (PEEP) have been associated with an increased survival. Veterinary dat synthesis: Two veterinary reports have characterized ARDS in dogs using human criteria. There are no prospective veterinary studies using recruitment that ventilator-induced lung injury (VILI) occurs in dogs, sheep, and rats. Conclusion: Recruitment maneuvers in conjunction with low tidal volumes and PEEP keep the alveoli open for gas exchange and decrease VILI. Prospective veterinary research in needed to determine if these maneuvers and recommendation can be applied to veterinary patients. [source]

    Protective ventilation to reduce inflammatory injury from one lung ventilation in a piglet model

    PEDIATRIC ANESTHESIA, Issue 4 2010
    MARY C. THEROUX MD
    Summary Objectives:, To test the hypothesis that protective ventilation strategy (PVS) as defined by the use of low stretch ventilation (tidal volume of 5 ml·kg,1 and employing 5 cm of positive end expiratory pressure (PEEP) during one lung ventilation (OLV) in piglets would result in reduced injury compared to a control group of piglets who received the conventional ventilation (tidal volume of 10 ml·kg,1 and no PEEP). Background:, PVS has been found to be beneficial in adults to minimize injury from OLV. We designed the current study to test the beneficial effects of PVS in a piglet model of OLV. Methods:, Ten piglets each were assigned to either ,Control' group (tidal volume of 10 ml·kg,1 and no PEEP) or ,PVS' group (tidal volume of 5 ml·kg,1 during the OLV phase and PEEP of 5 cm of H2O throughout the study). Experiment consisted of 30 min of baseline ventilation, 3 h of OLV, and again 30 min of bilateral ventilation. Respiratory parameters and proinflammatory markers were measured as outcome. Results:, There was no difference in PaO2 between groups. PaCO2 (P < 0.01) and ventilatory rate (P < 0.01) were higher at 1.5 h OLV and at the end point in the PVS group. Peak inflating pressure (PIP) and pulmonary resistance were higher (P < 0.05) in the control group at 1.5 h OLV. tumor necrosis factor-alpha (P < 0.04) and IL-8 were less (P < 0.001) in the plasma from the PVS group, while IL-6 and IL-8 were less (P < 0.04) in the lung tissue from ventilated lungs in the PVS group. Conclusions:, Based on this model, PVS decreases inflammatory injury both systemically and in the lung tissue with no adverse effect on oxygenation, ventilation, or lung function. [source]

    Lung Function Tests in Neonates and Infants with Chronic Lung Disease: Global and Regional Ventilation Inhomogeneity

    PEDIATRIC PULMONOLOGY, Issue 2 2006
    J. Jane Pillow FRACP
    Abstract This review considers measurement of global and regional ventilation inhomogeneity (VI) in infants and young children with acute neonatal respiratory disorders and chronic lung disease of infancy (CLDI). We focus primarily on multiple-breath inert gas washout (MBW) and electrical impedance tomography (EIT). The literature is critically reviewed and the relevant methods, equipment, and studies are summarized, including the limitations and strengths of individual techniques, together with the availability and appropriateness of any reference data. There has been a recent resurgence of interest in using MBW to monitor lung function within individuals and between different groups. In the mechanically ventilated, sedated, and paralyzed patient, VI indices can identify serial changes occurring following exogenous surfactant. Similarly, global VI indices appear to be increased in infants with CLDI and to differentiate between infants without lung disease and those with mild, moderate, and severe lung disease following preterm birth. While EIT is a relatively new technique, recent studies suggest that it is feasible in newborn infants, and can quantitatively identify changes in regional lung ventilation following alterations to ventilator settings, positive end expiratory pressure (PEEP), and administration of treatments such as surfactant. As such, EIT represents one of the more exciting prospects for continuous bedside pulmonary monitoring. For both techniques, there is an urgent need to establish guidelines regarding data collection, analysis, and interpretation in infants both with and without CLDI. © 2005 Wiley-Liss, Inc. [source]