scholarly journals Estimation of change in pleural pressure in assisted and unassisted spontaneous breathing pediatric patients using fluctuation of central venous pressure: A preliminary study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247360
Author(s):  
Nao Okuda ◽  
Miyako Kyogoku ◽  
Yu Inata ◽  
Kanako Isaka ◽  
Kazue Moon ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Spontaneous Breathing ◽  
Pediatric Patients ◽  
Venous Pressure ◽  
Balloon Catheter ◽  
Pleural Pressure ◽  
Respiratory Effort ◽  
Central Venous ◽  
Mechanically Ventilated ◽  
Esophageal Balloon

Background It is important to evaluate the size of respiratory effort to prevent patient self-inflicted lung injury and ventilator-induced diaphragmatic dysfunction. Esophageal pressure (Pes) measurement is the gold standard for estimating respiratory effort, but it is complicated by technical issues. We previously reported that a change in pleural pressure (ΔPpl) could be estimated without measuring Pes using change in CVP (ΔCVP) that has been adjusted with a simple correction among mechanically ventilated, paralyzed pediatric patients. This study aimed to determine whether our method can be used to estimate ΔPpl in assisted and unassisted spontaneous breathing patients during mechanical ventilation. Methods The study included hemodynamically stable children (aged <18 years) who were mechanically ventilated, had spontaneous breathing, and had a central venous catheter and esophageal balloon catheter in place. We measured the change in Pes (ΔPes), ΔCVP, and ΔPpl that was calculated using a corrected ΔCVP (cΔCVP-derived ΔPpl) under three pressure support levels (10, 5, and 0 cmH2O). The cΔCVP-derived ΔPpl value was calculated as follows: cΔCVP-derived ΔPpl = k × ΔCVP, where k was the ratio of the change in airway pressure (ΔPaw) to the ΔCVP during airway occlusion test. Results Of the 14 patients enrolled in the study, 6 were excluded because correct positioning of the esophageal balloon could not be confirmed, leaving eight patients for analysis (mean age, 4.8 months). Three variables that reflected ΔPpl (ΔPes, ΔCVP, and cΔCVP-derived ΔPpl) were measured and yielded the following results: -6.7 ± 4.8, − -2.6 ± 1.4, and − -7.3 ± 4.5 cmH2O, respectively. The repeated measures correlation between cΔCVP-derived ΔPpl and ΔPes showed that cΔCVP-derived ΔPpl had good correlation with ΔPes (r = 0.84, p< 0.0001). Conclusions ΔPpl can be estimated reasonably accurately by ΔCVP using our method in assisted and unassisted spontaneous breathing children during mechanical ventilation.

scholarly journals Respiratory variation of inferior vena cava diameter and central venous pressure in ventilated and non-ventilated children in fluid refractory septic shock: an observational study

2019 ◽  
Vol 6 (5) ◽  
pp. 1947
Author(s):  
Mohd Kashif Ali ◽  
Eeman Naim
Keyword(s):  
Septic Shock ◽  
Inferior Vena Cava ◽  
Central Venous Pressure ◽  
Inferior Vena ◽  
Venous Pressure ◽  
Vena Cava ◽  
Central Venous ◽  
Mechanically Ventilated ◽  
Spontaneously Breathing ◽  
Ventilated Patients

Background: Ultrasound guided fluid assessment in management of septic shock has come up as an adjunct to the current gold standard Central Venous Pressure monitoring. This study was designed to observe the respiro-phasic variation of IVC diameter (RV-IVCD) in invasively mechanically ventilated and spontaneously breathing paediatric patients of fluid refractory septic shock.Methods: This was a prospective observational study done at Paediatric intensive Care Unit (PICU) in Paediatric ward of Jawaharlal Nehru Medical College and Hospital (JNMCH) from February 2016 to June 2017. 107 consecutive patients between 1 year to 16 years age who were in shock despite 40ml/kg of fluid administration were included. Inferior Vena Cava (IVC) diameters were measured at end-expiration and end inspiration and the IVC collapsibility index was calculated. Simultaneously Central Venous Pressure (CVP) was recorded. Both values were obtained in ventilated and non-ventilated patients. Data was analysed to determine to look for the profile of RV-IVCD and CVP in ventilated and non-ventilated cases.Results: Out of 107 patients, 91 were on invasive mechanical ventilation and 16 patients were spontaneously breathing. There was a strong negative correlation between central venous pressure (CVP) and inferior vena cava collapsibility (RV-IVCD) in both spontaneously breathing (-0.810) and mechanically ventilated patients (-0.700). Negative correlation was significant in both study groups in CVP <8 mmHg and only in spontaneously breathing patients in CVP 8-12 mmHg range. IVC collapsibility showed a decreasing trend with rising CVP in both spontaneously breathing and mechanically ventilated patients.Conclusion: Ultrasonography guided IVCCI appears to be a valuable index in assessing fluid status in both spontaneously breathing and mechanically ventilated septic shock patients. However, more data is required from the paediatric population so as to define it as standard of practice.

scholarly journals ESTIMATION OF CENTRAL VENOUS PRESSURE IN PATIENTS ON MECHANICAL VENTILATION

2018 ◽  
Vol 71 (11) ◽  
pp. A1560
Author(s):  
Rupesh Ranjan ◽  
Yaser Alhamshari ◽  
Georgios Lygouris ◽  
Vincent Figueredo ◽  
Raina Sinha ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Central Venous Pressure ◽  
Venous Pressure ◽  
Central Venous

scholarly journals Effect of Positive End Expiratory Pressure on Central Venous Pressure in Mechanically Ventilated Patients

2019 ◽  
Vol 7 (3) ◽  
pp. 387-391
Author(s):  
Khaled Mohammed Al-Sayaghi ◽  
Hassnaa Eid Shaban Mosa ◽  
Masouda Hassan Atrous ◽  
Azza Hamdi El-Soussi ◽  
Ahmed Youssef Ali ◽  
...  
Keyword(s):  
Central Venous Pressure ◽  
Venous Pressure ◽  
Positive End Expiratory Pressure ◽  
Central Venous ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

scholarly journals Immediate effects of manual hyperinflation on cardiorespiratory function and sputum clearance in mechanically ventilated pediatric patients: A randomized crossover trial

2021 ◽  
pp. 1-8
Author(s):  
Tawatchai Luadsri ◽  
Jaturon Boonpitak ◽  
Kultida Pongdech-Udom ◽  
Patnuch Sukpom ◽  
Weerapong Chidnok
Keyword(s):  
Blood Pressure ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Pediatric Patients ◽  
Physical Therapist ◽  
Peak Inspiratory Pressure ◽  
Lung Compliance ◽  
Post Intervention ◽  
Mechanically Ventilated ◽  
Arterial Blood

Background: In developing countries, lower respiratory tract infection is a major cause of death in children, with severely ill patients being admitted to the critical-care unit. While physical therapists commonly use the manual hyperinflation (MHI) technique for secretion mass clearance in critical-care patients, its efficacy has not been determined in pediatric patients. Objective:This study investigated the effects of MHI on secretion mass clearance and cardiorespiratory responses in pediatric patients undergoing mechanical ventilation. Methods:A total of 12 intubated and mechanically ventilated pediatric patients were included in this study. At the same time of the day, the patients received two randomly ordered physical therapy treatments (MHI with suction and suction alone) from a trained physical therapist, with a washout period of 4[Formula: see text]h provided between interventions. Results:The MHI treatment increased the tidal volume [[Formula: see text]; 1.2[Formula: see text]mL/kg (95% CI, 0.8–1.5)] and static lung compliance [[Formula: see text]; 3.7[Formula: see text]mL/cmH2O (95% CI, 2.6–4.8)] immediately post-intervention compared with the baseline ([Formula: see text]). Moreover, the MHI with suction induced higher [Formula: see text] [1.4[Formula: see text]mL/kg (95% CI, 0.8–2.1)] and [Formula: see text] [3.4[Formula: see text]mL/cmH2O (95% CI, 2.1–4.7)] compared with the suction-alone intervention. In addition, the secretion mass [0.7[Formula: see text]g (95% CI, 0.6–0.8)] was greater in MHI with suction compared with suction alone ([Formula: see text]). However, there was no difference in peak inspiratory pressure, mean airway pressure, respiratory rate, heart rate, blood pressure, mean arterial blood pressure or oxygen saturation ([Formula: see text]) between interventions. Conclusions:MHI can improve [Formula: see text], [Formula: see text] and secretion mass without inducing adverse hemodynamic effects upon the pediatric patients requiring mechanical ventilation.

Effective respiratory system elastance during positive-pressure breathing in supine man

1975 ◽  
Vol 39 (4) ◽  
pp. 541-547 ◽  
Author(s):  
W. T. Josenhans ◽  
T. A. Peacocke ◽  
G. Schaller
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory System ◽  
Spontaneous Breathing ◽  
Lung Compliance ◽  
Abdominal Muscle ◽  
Positive Pressure ◽  
Passive Components ◽  
Mechanically Ventilated ◽  
Airway Opening ◽  
Healthy Males

Two healthy males relaxing supine on a ballistobed were mechanically ventilated at positive end-expiratory pressures (PEEP) from 0 to 19 cmH2O. Pressures at the airway opening, middle esophagus, and stomach were monitored, together with tidal volume (VT) and ballistobed displacement. The effective elastance (i.e., sum of active and passive components) of the respiratory system (E'rs) and its components--abdominal muscle (E'ab), diaphragm (E'di), and rib cage (E'rc)--were calculated. With increasing PEEP, lung compliance increased slightly, E'rc and E'di decreased linearly, and E'ab increased linearly. The combined effective elastance of abdomen and diaphragm (E'ab+di) first decreased and then increased again. The abdomen-diaphragm contribution to VT during mechanical ventilation was approximately half that of spontaneous breathing.

scholarly journals Studies on Australian Snake Venoms. Part 1: The Haemodynamic Effects of Brown Snake (Pseudonaja) Species in the Dog

1989 ◽  
Vol 17 (4) ◽  
pp. 466-469 ◽  
Author(s):  
J. Tibballs ◽  
S. Sutherland ◽  
S. Kerr
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Venous Pressure ◽  
Haemodynamic Effects ◽  
Peripheral Vascular ◽  
Snake Venoms ◽  
Central Venous ◽  
Induced Hypotension ◽  
Mechanically Ventilated

The haemodynanic effects of Brown Snake (Pseudonaja) species (textilis, nuchalis, affinis) were investigated in anaesthetised, mechanically ventilated dogs. Blood pressure decreased to minimal levels five minutes after intravenous envenomation. Hypotension was accompanied by significant decrements in cardiac output and stroke volume and a rise in peripheral vascular resistance. Heart rate increased transiently during 0.5-2.0 minutes after envenomation but had declined below resting levels five minutes after envenomation. No statistically significant change was recorded in central venous pressure. Depression of myocardial contractility is postulated as the mechanism of venom induced hypotension.

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