131 PEAK INSPIRATORY PRESSURE (PIP) OVERSHOOTS ON SOME INFANT VENTILATORS DURING ACTIVE EXPIRATION

Using open-magnitude scaling we studied the importance of ventilatory drive on the perceived magnitude of respiratory loads by applying a range of externally added resistances (2.1–77.1 cmH2O X l-1 X s) to normal subjects at rest and at three increasing levels of ventilatory drive induced by exercise, CO2-stimulated breathing, and hypoxia. Under all conditions studied the perceived magnitude of the added loads increased with the magnitude of the resistive load and as the underlying level of ventilatory drive increased. When the results were expressed in terms of peak inspiratory pressure, the perceived magnitude was related to the magnitude of the peak inspiratory pressure by a power function (mean r = 0.97). These results suggest that the perceived magnitude of added resistive loads increased with increasing ventilatory drive, in such a manner that the increase in sensory magnitude is proportional to the increase in the inspiratory muscle force developed and suggests that something dependent on this force mediates the sensation.

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Periodic funnel-based control for peak inspiratory pressure

2015 54th IEEE Conference on Decision and Control (CDC) ◽

10.1109/cdc.2015.7403100 ◽

2015 ◽

Cited By ~ 9

Author(s):

Anake Pomprapa ◽

Soren Weyer ◽

Steffen Leonhardt ◽

Marian Walter ◽

Berno Misgeld

Keyword(s):

Peak Inspiratory Pressure ◽

Inspiratory Pressure

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Impact of lung compliance on neurological outcome in patients with acute respiratory distress syndrome following out-of-hospital cardiac arrest

10.21203/rs.2.20594/v1 ◽

2020 ◽

Author(s):

June-Sung Kim ◽

Youn-Jung Kim ◽

Muyeol Kim ◽

Seung Mok Ryoo ◽

Chang Hwan Sohn ◽

...

Keyword(s):

Cardiac Arrest ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Neurological Outcome ◽

Distress Syndrome ◽

Peak Inspiratory Pressure ◽

Lung Compliance ◽

Inspiratory Pressure ◽

Neurologic Outcome ◽

Hospital Cardiac Arrest

Abstract Background Acute respiratory distress syndrome (ARDS) following cardiac arrest is common and associated with in-hospital mortality. We aimed to investigate whether lung compliance during targeted temperature management is associated with neurological outcome in patients with ARDS after out-of-hospital cardiac arrest (OHCA).Methods This observational study was conducted in the emergency intensive care unit from January 2011 to April 2019 using data from a prospective patient registry. Adult patients (age ≥18 years) who survived non-traumatic OHCA and subsequently developed ARDS based on the Berlin definition were included. Mechanical ventilator parameters such as peak inspiratory pressure, tidal volume, minute ventilation, positive end expiratory pressure, and compliance were recorded for 7 days or until death, and categorized as maximum, median, and minimum. The primary outcome was favorable neurological outcome defined as Cerebral Performance Category score 1 or 2 at hospital discharge.Results Of 246 OHCA survivors, 119 (48.4%) patients developed ARDS. A favorable neurologic outcome was observed in 23 (19.3%). Patients with favorable outcome had significantly higher lung compliance (38.6 cm H 2 O vs 27.5 cm H 2 O), lower inspiratory pressure (12.0 cm H 2 O vs 16.0 cm H 2 O), and lower peak inspiratory pressure (17.0 cm H 2 O vs 21.0 cm H 2 O) than those with poor neurologic outcome (all P <0.01). In time-dependent cox regression models, all maximum (hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.03-1.08), minimum (HR 1.08, 95% CI 1.04 – 1.12), and median (HR 1.06, 95% CI 1.03-1.10) compliances were independently associated with good neurologic outcome. Median compliance > 31.4 mL/cm H 2 O at day 1 had the highest area under the receiver operating characteristic curve (0.732) with positive predictive value of 90%.Conclusion Lung compliance may be an early predictor of neurologic intact survival in patients with ARDS following cardiac arrest.

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Evaluation of peak inspiratory pressure, tidal volume and respiratory rate during ventilation of premature lambs using a self-inflating bag

Jornal de Pediatria ◽

10.2223/jped.1517 ◽

2006 ◽

Vol 82 (4) ◽

pp. 279-283 ◽

Cited By ~ 7

Author(s):

Jefferson G. Resende ◽

Carlos A. M. Zaconeta ◽

Antônio C. P. Ferreira ◽

César A. M. Silva ◽

Marcelo P. Rodrigues ◽

...

Keyword(s):

Tidal Volume ◽

Respiratory Rate ◽

Peak Inspiratory Pressure ◽

Inspiratory Pressure

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Effect of peak inspiratory pressure on the filtration coefficient in the isolated perfused rat lung

Journal of Applied Physiology ◽

10.1152/jappl.1993.74.6.3068 ◽

1993 ◽

Vol 74 (6) ◽

pp. 3068-3072 ◽

Cited By ~ 9

Author(s):

G. Omlor ◽

G. D. Niehaus ◽

M. B. Maron

Keyword(s):

Cardiac Output ◽

Peak Inspiratory Pressure ◽

Filtration Coefficient ◽

Inspiratory Pressure ◽

Rat Lungs ◽

Normal Rat ◽

The Stability ◽

Isolated Lungs ◽

Peak Pressures ◽

Isolated Rat

Positive inspiratory pressure- (PIP) ventilated, isolated rat lungs become edematous when perfused at rates approximately the normal cardiac output. The study was conducted to test the hypothesis that high peak inspiratory pressures contribute to the edema development. Five isolated lungs were perfused at a rate of 24.4 +/- 2.2 ml.min-1.100 g body wt-1 with 40% whole blood (diluted with saline containing 4.0 g/100 ml bovine serum albumin) and ventilated with peak pressures ranging from 0 to 20 mmHg. The lungs exhibited edema at PIP values > 9.3 mmHg. The stable pulmonary vascular pressure and resistance suggested that the edema may have resulted from a PIP-induced increase in microvascular permeability. In a second study, the stability of the preparation was evaluated during a 3-h test period. Seven lungs were ventilated at a peak inspiratory pressure of 8.0 mmHg and perfused at 26.8 +- 1.7 ml.min-1 x 100 g body wt-1. Microvascular integrity was maintained for approximately 2 h as indicated by filtration coefficient measurements of 0.175 +/- 0.068, 0.197 +/- 0.066, and 0.169 +/- 0.067 g.min-1 x mmHg-1 x 100 g-1 at 25, 70, and 115 min, respectively, after initiation of the study. The results suggest that isolated rat lungs perfused at rates that parallel normal rat cardiac output and ventilated at low peak inspiratory pressures provide a viable mechanism for evaluation of the pathophysiology of microvascular injury.

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Determinants of gas flow through a bronchopleural fistula

Journal of Applied Physiology ◽

10.1152/jappl.1989.67.4.1591 ◽

1989 ◽

Vol 67 (4) ◽

pp. 1591-1596 ◽

Cited By ~ 12

Author(s):

M. C. Walsh ◽

W. A. Carlo

Keyword(s):

Airway Pressure ◽

Gas Flow ◽

Bronchopleural Fistula ◽

Peak Inspiratory Pressure ◽

Intrathoracic Pressure ◽

Transpulmonary Pressure ◽

Inspiratory Pressure ◽

Positive End Expiratory Pressure ◽

Inspiratory Time ◽

Mean Airway Pressure

To assess the determinants of bronchopleural fistula (BPF) flow, we used a surgically created BPF to study 15 anesthetized intubated mechanically ventilated New Zealand White rabbits. Mean airway pressure and intrathoracic pressure were evaluated independently. Mean airway pressure was varied (8, 10, or 12 cmH2O) by independent manipulations of either peak inspiratory pressure, positive end-expiratory pressure, or inspiratory time. Intrathoracic pressure was varied from 0 to -40 cmH2O. BPF flow varied directly with mean airway pressure (P less than 0.001). However, at constant mean airway pressure, BPF flow was not influenced independently by changes in peak inspiratory pressure, positive end-expiratory pressure, or inspiratory time. Resistance of the BPF increased as intrathoracic pressure became more negative. Despite increased resistance, BPF flow also increased. BPF resistance was constant over the range of mean airway (P less than 0.01) pressures investigated. Our data document the influence of mean airway pressure and intrathoracic pressure on BPF flow and suggest that manipulations which reduce transpulmonary pressure will decrease BPF flow.

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