scholarly journals Lung simulation to support non-invasive pulmonary blood flow measurement in Acute Respiratory Distress Syndrome in animals*

2021 ◽  
Author(s):  
Minh C. Tran ◽  
Douglas C. Crockett ◽  
Arun Joseph ◽  
Federico Formenti ◽  
Phi A. Phan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Blood Flow ◽  
Flow Measurement ◽  
Distress Syndrome ◽  
Blood Flow Measurement ◽  
Non Invasive ◽  
Lung Simulation

Non-invasive measurement of pulmonary blood flow during prone positioning in patients with early acute respiratory distress syndrome

2004 ◽  
Vol 106 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Jörg REUTERSHAN ◽  
Andre SCHMITT ◽  
Klaus DIETZ ◽  
Reinhold FRETSCHNER
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Pulmonary Blood Flow ◽  
Distress Syndrome ◽  
Prone Positioning ◽  
Intrapulmonary Shunt ◽  
Non Invasive

In the daily clinical routine at the bedside, information on effective pulmonary blood flow (PBF) is limited and requires invasive monitoring, including a pulmonary artery catheter, to determine both cardiac output and intrapulmonary shunt. Therefore we evaluated a non-invasive method for the measurement of PBF in a clinical setting, including 12 patients with acute respiratory failure (acute respiratory distress syndrome) undergoing prone positioning. PBF was determined before (baseline), during and after prone positioning, by using a foreign gas rebreathing method with a new photoacoustic gas analyser. Values were compared with the cardiac output corrected for intrapulmonary shunt (COeff). Responders to prone positioning were defined according to the improvement of arterial oxygenation. A total of 84 measurements were performed. PBF values correlated well with COeff (R2=0.96; P<0.0001). Bias and limits of agreement (±2 S.D.) for all measurements were -0.11±0.76 litre/min. At baseline, responders showed significantly lower PBF levels than non-responders (4.8±1.0 compared with. 6.4±1.2 litre/min; P=0.03). During prone positioning, PBF increased continuously in responders and remained high after patients had been returned to the supine position. PBF was unaffected in non-responders. Mean total increase in PBF was 1.2±0.2 litre/min in responders compared with -0.4±0.2 litre/min in non-responders (P<0.0001). In conclusion, the investigated rebreathing system allows for a non-invasive determination of PBF at the bedside. The accuracy of the measurements is comparable with the thermodilution method. It is able to reliably reflect changes in PBF induced by prone positioning. Moreover, measuring PBF might be a promising tool to identify responders to prone therapy.

Barotrauma during non-invasive ventilation for acute respiratory distress syndrome caused by COVID-19: a balance between risks and benefits

2021 ◽  
Vol 82 (6) ◽  
pp. 1-9
Author(s):  
M Gabrielli ◽  
F Valletta ◽  
F Franceschi ◽  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Ventilatory support is vital for the management of severe forms of COVID-19. Non-invasive ventilation is often used in patients who do not meet criteria for intubation or when invasive ventilation is not available, especially in a pandemic when resources are limited. Despite non-invasive ventilation providing effective respiratory support for some forms of acute respiratory failure, data about its effectiveness in patients with viral-related pneumonia are inconclusive. Acute respiratory distress syndrome caused by severe acute respiratory syndrome-coronavirus 2 infection causes life-threatening respiratory failure, weakening the lung parenchyma and increasing the risk of barotrauma. Pulmonary barotrauma results from positive pressure ventilation leading to elevated transalveolar pressure, and in turn to alveolar rupture and leakage of air into the extra-alveolar tissue. This article reviews the literature regarding the use of non-invasive ventilation in patients with acute respiratory failure associated with COVID-19 and other epidemic or pandemic viral infections and the related risk of barotrauma.

Noninvasive monitoring of nonshunted pulmonary capillary blood flow in the acute respiratory distress syndrome

2000 ◽  
Vol 28 (4) ◽  
pp. 1059-1067 ◽  
Author(s):  
Karan J. K. Kanhai ◽  
Henk Strijdhorst ◽  
Jan C. Pompe ◽  
Wim P. J. Holland ◽  
Eveline G. J. Ong ◽  
...  
Keyword(s):  
Blood Flow ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Capillary Blood ◽  
Capillary Blood Flow ◽  
Pulmonary Capillary Blood Flow ◽  
Pulmonary Capillary ◽  
Pulmonary Capillary Blood
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