scholarly journals Effect of high-flow nasal cannula oxygen on diaphragmatic excursion and lung volumes determined by electrical impedance tomography

2015 ◽  
Vol 3 (S1) ◽  
Author(s):  
S Perbet ◽  
S Bertran ◽  
B Longere ◽  
B Pereira ◽  
E Futier ◽  
...  
Keyword(s):  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Impedance Tomography ◽  
Lung Volumes

scholarly journals First Attempt at Using Electrical Impedance Tomography to Predict High Flow Nasal Cannula Therapy Outcomes at an Early Phase

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhe Li ◽  
Zhiyun Zhang ◽  
Qian Xia ◽  
Danling Xu ◽  
Shaojie Qin ◽  
...  
Keyword(s):  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Final Analysis ◽  
High Flow ◽  
Nasal Cannula ◽  
Time To Failure ◽  
High Flow Nasal Cannula ◽  
Impedance Tomography ◽  
Rapid Shallow Breathing Index ◽  
Significant Difference

Objective: Spatial and temporal ventilation distributions in patients with acute respiratory failure during high flow nasal cannula (HFNC) therapy were previously studied with electrical impedance tomography (EIT). The aim of the study was to explore the possibility of predicting HFNC failure based on various EIT-derived parameters.Methods: High flow nasal cannula failure was defined reintubation within 48 h after HFNC. EIT was performed with the patients spontaneously breathing in the supine position at the start of HFNC. EIT-based indices (comprising the global inhomogeneity index, center of ventilation, ventilation delay, rapid shallow breathing index, minute volume, and inspiration to expiration time) were explored and evaluated at three time points (prior to HFNC, T1; 30 min after HFNC started, T2; and 1 h after, T3).Results: A total of 46 subjects were included in the final analysis. Eleven subjects had failed HFNC. The time to failure was 27.8 ± 12.4 h. The ROX index (defined as SpO2/FiO2/respiratory rate) for HFNC success patients was 8.3 ± 2.7 and for HFNC failure patients, 6.2 ± 1.8 (p = 0.23). None of the investigated EIT-based parameters showed significant differences between subjects with HFNC failure and success. Further subgroup analysis indicated that a significant difference in ventilation inhomogeneity was found between ARDS and non-ARDS [0.54 (0.37) vs. 0.46 (0.28) as evaluated with GI, p < 0.01]. Ventilation homogeneity significantly improved in ARDS after 60-min HFNC treatment [0.59 (0.20) vs 0.57 (0.19), T1 vs. T3, p < 0.05].Conclusion: Spatial and temporal ventilation distributions were slightly but insignificantly different between the HFNC success and failure groups. HFNC failure could not be predicted by changes in EIT temporal and spatial indexes of ventilation distribution within the first hour. Further studies are required to predict the outcomes of HFNC.

Respiratory Drive in Patients with Sepsis and Septic Shock: Modulation by High-flow Nasal Cannula

2021 ◽  
Author(s):  
Tommaso Mauri ◽  
Elena Spinelli ◽  
Bertrand Pavlovsky ◽  
Domenico Luca Grieco ◽  
Irene Ottaviani ◽  
...  
Keyword(s):  
Septic Shock ◽  
Esophageal Pressure ◽  
Lung Compliance ◽  
High Flow ◽  
Nasal Cannula ◽  
Low Flow ◽  
Respiratory Drive ◽  
High Flow Nasal Cannula ◽  
Impedance Tomography ◽  
Sepsis And Septic Shock

Background Experimental and pilot clinical data suggest that spontaneously breathing patients with sepsis and septic shock may present increased respiratory drive and effort, even in the absence of pulmonary infection. The study hypothesis was that respiratory drive and effort may be increased in septic patients and correlated with extrapulmonary determinant and that high-flow nasal cannula may modulate drive and effort. Methods Twenty-five nonintubated patients with extrapulmonary sepsis or septic shock were enrolled. Each patient underwent three consecutive steps: low-flow oxygen at baseline, high-flow nasal cannula, and then low-flow oxygen again. Arterial blood gases, esophageal pressure, and electrical impedance tomography data were recorded toward the end of each step. Respiratory effort was measured as the negative swing of esophageal pressure (ΔPes); drive was quantified as the change in esophageal pressure during the first 500 ms from start of inspiration (P0.5). Dynamic lung compliance was calculated as the tidal volume measured by electrical impedance tomography, divided by ΔPes. The results are presented as medians [25th to 75th percentile]. Results Thirteen patients (52%) were in septic shock. The Sequential Organ Failure Assessment score was 5 [4 to 9]. During low-flow oxygen at baseline, respiratory drive and effort were elevated and significantly correlated with arterial lactate (r = 0.46, P = 0.034) and inversely with dynamic lung compliance (r = –0.735, P < 0.001). Noninvasive support by high-flow nasal cannula induced a significant decrease of respiratory drive (P0.5: 6.0 [4.4 to 9.0] vs. 4.3 [3.5 to 6.6] vs. 6.6 [4.9 to 10.7] cm H2O, P < 0.001) and effort (ΔPes: 8.0 [6.0 to 11.5] vs. 5.5 [4.5 to 8.0] vs. 7.5 [6.0 to 12.6] cm H2O, P < 0.001). Oxygenation and arterial carbon dioxide levels remained stable during all study phases. Conclusions Patients with sepsis and septic shock of extrapulmonary origin present elevated respiratory drive and effort, which can be effectively reduced by high-flow nasal cannula. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

A Calibration Technique for the Estimation of Lung Volumes in Nonintubated Subjects by Electrical Impedance Tomography

Respiration ◽  
2019 ◽  
Vol 98 (3) ◽  
pp. 189-197 ◽  
Author(s):  
Simone Sosio ◽  
Giacomo Bellani ◽  
Silvia Villa ◽  
Ermes Lupieri ◽  
Tommaso Mauri ◽  
...  
Keyword(s):  
Electrical Impedance Tomography ◽  
Electrical Impedance ◽  
Calibration Technique ◽  
Impedance Tomography ◽  
Lung Volumes

scholarly journals Effects of high-flow nasal cannula therapy on oxygenation, lung volumes and CO2 removal in critically ill hypoxemic patients: preliminary results

Critical Care ◽  
2015 ◽  
Vol 19 (Suppl 1) ◽  
pp. P201
Author(s):  
T Mauri ◽  
N Eronia ◽  
G Bellani ◽  
G Grasselli ◽  
R Marcolin ◽  
...  
Keyword(s):  
Critically Ill ◽  
High Flow ◽  
Nasal Cannula ◽  
Co2 Removal ◽  
High Flow Nasal Cannula ◽  
Lung Volumes ◽  
Preliminary Results
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