Thoracoabdominal Compression and Respiratory System Compliance in HIV-infected Infants

2000 ◽  
Vol 161 (5) ◽  
pp. 1567-1571 ◽  
Author(s):  
ARNOLD C. G. PLATZKER ◽  
ANDREW A. COLIN ◽  
XIN C. CHEN ◽  
PETER HIATT ◽  
JANICE HUNTER ◽  
...  
Keyword(s):  
Respiratory System ◽  
Respiratory System Compliance

scholarly journals Robustness of two different methods of monitoring respiratory system compliance during mechanical ventilation

2017 ◽  
Vol 55 (10) ◽  
pp. 1819-1828 ◽  
Author(s):  
Gaetano Perchiazzi ◽  
Christian Rylander ◽  
Mariangela Pellegrini ◽  
Anders Larsson ◽  
Göran Hedenstierna
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory System ◽  
Respiratory System Compliance

scholarly journals Thoracic sympathetic block reduces respiratory system compliance

2007 ◽  
Vol 125 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Fábio Ely Martins Benseñor ◽  
Joaquim Edson Vieira ◽  
José Otávio Costa Auler Júnior
Keyword(s):  
Chest Wall ◽  
Respiratory System ◽  
Lung Resection ◽  
Lung Compliance ◽  
Airway Hyperreactivity ◽  
Sympathetic Block ◽  
Respiratory System Compliance ◽  
Double Blind ◽  
Thoracic Epidural ◽  
Student’S T

CONTEXT AND OBJECTIVE: Thoracic epidural anesthesia (TEA) following thoracic surgery presents known analgesic and respiratory benefits. However, intraoperative thoracic sympathetic block may trigger airway hyperreactivity. This study weighed up these beneficial and undesirable effects on intraoperative respiratory mechanics. DESIGN AND SETTING: Randomized, double-blind clinical study at a tertiary public hospital. METHODS: Nineteen patients scheduled for partial lung resection were distributed using a random number table into groups receiving active TEA (15 ml 0.5% bupivacaine, n = 9) or placebo (15 ml 0.9% saline, n = 10) solutions that also contained 1:200,000 epinephrine and 2 mg morphine. Under general anesthesia, flows and airway and esophageal pressures were recorded. Pressure-volume curves, lower inflection points (LIP), resistance and compliance at 10 ml/kg tidal volume were established for respiratory system, chest wall and lungs. Student’s t test was performed, including confidence intervals (CI). RESULTS: Bupivacaine rose 5 ± 1 dermatomes upwards and 6 ± 1 downwards. LIP was higher in the bupivacaine group (6.2 ± 2.3 versus 3.6 ± 0.6 cmH2O, p = 0.016, CI = -3.4 to -1.8). Respiratory system and lung compliance were higher in the placebo group (respectively 73.3 ± 10.6 versus 51.9 ± 15.5, p = 0.003, CI = 19.1 to 23.7; 127.2 ± 31.7 versus 70.2 ± 23.1 ml/cmH2O, p < 0.001, CI = 61 to 53). Resistance and chest wall compliance showed no difference. CONCLUSION: TEA decreased respiratory system compliance by reducing its lung component. Resistance was unaffected. Under TEA, positive end-expiratory pressure and recruitment maneuvers are advisable.

scholarly journals The correlation of respiratory system compliance and mortality in COVID-19 acute respiratory distress syndrome: do phenotypes really exist?

2021 ◽  
Vol 8 (2) ◽  
pp. 67-74
Author(s):  
Rachel L. Choron ◽  
Stephen A. Iacono ◽  
Alexander Cong ◽  
Christopher G. Bargoud ◽  
Amanda L. Teichman ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory System ◽  
Management Strategies ◽  
Respiratory System Compliance ◽  
Risk Of Death ◽  
Mortality Difference ◽  
Ventilator Management ◽  
Observational Cohort ◽  
Multivariable Regression ◽  
The Mean

Background: Recent literature suggests respiratory system compliance (Crs) based phenotypes exist among COVID-19 ARDS patients. We sought to determine whether these phenotypes exist and whether Crs predicts mortality. Methods: A retrospective observational cohort study of 111 COVID-19 ARDS patients admitted March 11-July 8, 2020. Crs was averaged for the first 72-hours of mechanical ventilation. Crs<30ml/cmH2O was defined as poor Crs(phenotype-H) whereas Crs≥30ml/cmH2O as preserved Crs(phenotype-L). Results: 111 COVID-19 ARDS patients were included, 40 phenotype-H and 71 phenotype-L. Both the mean PaO2/FiO2 ratio for the first 72-hours of mechanical ventilation and the PaO2/FiO2 ratio hospital nadir were lower in phenotype-H than L(115[IQR87] vs 165[87], p=0.016), (63[32] vs 75[59], p=0.026). There were no difference in characteristics, diagnostic studies, or complications between groups. Twenty-seven (67.5%) phenotype-H patients died vs 37(52.1%) phenotype-L(p=0.115). Multivariable regression did not reveal a mortality difference between phenotypes; however, a 2-fold mortality increase was noted in Crs<20 vs >50ml/cmH2O when analyzing ordinal Crs groups. Moving up one group level (ex. Crs30-39.9ml/cmH2O to 40-49.9ml/cmH2O), was marginally associated with 14% lower risk of death(RR=0.86, 95%CI 0.72, 1.01, p=0.065). This attenuated (RR=0.94, 95%CI 0.80, 1.11) when adjusting for pH nadir and PaO2/FiO2 ratio nadir. Conclusion: We identified a spectrum of Crs in COVID-19 ARDS similar to Crs distribution in non-COVID-19 ARDS. While we identified increasing mortality as Crs decreased, there was no specific threshold marking significantly different mortality based on phenotype. We therefore would not define COVID-19 ARDS patients by phenotypes-H or L and would not stray from traditional ARDS ventilator management strategies.

scholarly journals 173 DETERMINATION OF TOTAL. RESPIRATORY SYSTEM COMPLIANCE FROM RESONANT FREQUENCY IN INTUBATED SLBJECTS

1990 ◽  
Vol 28 (3) ◽  
pp. 306-306
Author(s):  
Andreas Schulze ◽  
Peter Schaller ◽  
Jürgen Dinger ◽  
Dieter Gmyrek
Keyword(s):  
Resonant Frequency ◽  
Respiratory System ◽  
Respiratory System Compliance

Assessment of respiratory system compliance by a flow recording method

1995 ◽  
Vol 39 (4) ◽  
pp. 462-466 ◽  
Author(s):  
M. Darowski ◽  
I. Gottlieb-Inacio ◽  
U. Ludwigs ◽  
G. Hedenstierna
Keyword(s):  
Respiratory System ◽  
Respiratory System Compliance ◽  
Recording Method

scholarly journals Driving Pressure Is Associated with Outcome during Assisted Ventilation in Acute Respiratory Distress Syndrome

2019 ◽  
Vol 131 (3) ◽  
pp. 594-604 ◽  
Author(s):  
Giacomo Bellani ◽  
Alice Grassi ◽  
Simone Sosio ◽  
Stefano Gatti ◽  
Brian P. Kavanagh ◽  
...  
Keyword(s):  
Respiratory System ◽  
Odds Ratio ◽  
Pressure Support ◽  
Distress Syndrome ◽  
Peak Pressure ◽  
Plateau Pressure ◽  
Assisted Ventilation ◽  
Driving Pressure ◽  
Respiratory System Compliance ◽  
Controlled Mechanical Ventilation

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Driving pressure, the difference between plateau pressure and positive end-expiratory pressure (PEEP), is closely associated with increased mortality in patients with acute respiratory distress syndrome (ARDS). Although this relationship has been demonstrated during controlled mechanical ventilation, plateau pressure is often not measured during spontaneous breathing because of concerns about validity. The objective of the present study is to verify whether driving pressure and respiratory system compliance are independently associated with increased mortality during assisted ventilation (i.e., pressure support ventilation). Methods This is a retrospective cohort study conducted on 154 patients with ARDS in whom plateau pressure during the first three days of assisted ventilation was available. Associations between driving pressure, respiratory system compliance, and survival were assessed by univariable and multivariable analysis. In patients who underwent a computed tomography scan (n = 23) during the stage of assisted ventilation, the quantity of aerated lung was compared with respiratory system compliance measured on the same date. Results In contrast to controlled mechanical ventilation, plateau pressure during assisted ventilation was higher than the sum of PEEP and pressure support (peak pressure). Driving pressure was higher (11 [9–14] vs. 10 [8–11] cm H2O; P = 0.004); compliance was lower (40 [30–50] vs. 51 [42–61] ml · cm H2O-1; P &lt; 0.001); and peak pressure was similar, in nonsurvivors versus survivors. Lower respiratory system compliance (odds ratio, 0.92 [0.88–0.96]) and higher driving pressure (odds ratio, 1.34 [1.12–1.61]) were each independently associated with increased risk of death. Respiratory system compliance was correlated with the aerated lung volume (n = 23, r = 0.69, P &lt; 0.0001). Conclusions In patients with ARDS, plateau pressure, driving pressure, and respiratory system compliance can be measured during assisted ventilation, and both higher driving pressure and lower compliance are associated with increased mortality.

Sign in / Sign up

Export Citation Format

Share Document