scholarly journals Assessing the Asynchrony Event Based on the Ventilation Mode for Mechanically Ventilated Patients in ICU

2021 ◽  
Vol 8 (12) ◽  
pp. 222
Author(s):  
Nur Sa’adah Muhamad Sauki ◽  
Nor Salwa Damanhuri ◽  
Nor Azlan Othman ◽  
Belinda Chong Chiew Meng ◽  
Yeong Shiong Chiew ◽  
...  
Keyword(s):  
Respiratory Mechanics ◽  
Lung Mechanics ◽  
System Modelling ◽  
Time Varying ◽  
Ventilation Mode ◽  
Model Data ◽  
Mechanically Ventilated ◽  
Model Based ◽  
Incorrect Measurement ◽  
Event Based

Respiratory system modelling can assist clinicians in making clinical decisions during mechanical ventilation (MV) management in intensive care. However, there are some cases where the MV patients produce asynchronous breathing (asynchrony events) due to the spontaneous breathing (SB) effort even though they are fully sedated. Currently, most of the developed models are only suitable for fully sedated patients, which means they cannot be implemented for patients who produce asynchrony in their breathing. This leads to an incorrect measurement of the actual underlying mechanics in these patients. As a result, there is a need to develop a model that can detect asynchrony in real-time and at the bedside throughout the ventilated days. This paper demonstrates the asynchronous event detection of MV patients in the ICU of a hospital by applying a developed extended time-varying elastance model. Data from 10 mechanically ventilated respiratory failure patients admitted at the International Islamic University Malaysia (IIUM) Hospital were collected. The results showed that the model-based technique precisely detected asynchrony events (AEs) throughout the ventilation days. The patients showed an increase in AEs during the ventilation period within the same ventilation mode. SIMV mode produced much higher asynchrony compared to SPONT mode (p < 0.05). The link between AEs and the lung elastance (AUC Edrs) was also investigated. It was found that when the AEs increased, the AUC Edrs decreased and vice versa based on the results obtained in this research. The information of AEs and AUC Edrs provides the true underlying lung mechanics of the MV patients. Hence, this model-based method is capable of detecting the AEs in fully sedated MV patients and providing information that can potentially guide clinicians in selecting the optimal ventilation mode of MV, allowing for precise monitoring of respiratory mechanics in MV patients.

Constrained Time-Varying System Modelling

1988 ◽  
Author(s):  
Jerome R. Bellegarda ◽  
David C. Farden
Keyword(s):  
System Modelling ◽  
Time Varying

Auto-PEEP effects on respiratory mechanics and blood gases in mechanically ventilated patients

1998 ◽  
Vol 74 (4) ◽  
pp. 275-83
Author(s):  
Antônio C. P. Ferreira ◽  
Benjamin I. Kopelman ◽  
Werther Brunow de Carvalho ◽  
Jorge Bonassa
Keyword(s):  
Respiratory Mechanics ◽  
Blood Gases ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

scholarly journals Model-based feed-forward control for time-varying systems with an example for SRF cavities

2020 ◽  
Vol 53 (2) ◽  
pp. 1331-1336
Author(s):  
Sven Pfeiffer ◽  
Annika Eichler ◽  
Holger Schlarb
Keyword(s):  
Time Varying ◽  
Feed Forward ◽  
Feed Forward Control ◽  
Model Based ◽  
Time Varying Systems ◽  
Srf Cavities

scholarly journals Effect of pressure-controlled ventilation-volume guaranteed mode combined with individualized positive end-expiratory pressure on respiratory mechanics, oxygenation and lung injury in patients undergoing laparoscopic surgery in Trendelenburg position

2021 ◽  
Author(s):  
Jianli Li ◽  
Saixian Ma ◽  
Xiujie Chang ◽  
Songxu Ju ◽  
Meng Zhang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Lung Injury ◽  
Respiratory Mechanics ◽  
Lung Mechanics ◽  
Trial Registry ◽  
Positive End Expiratory Pressure ◽  
Clinical Trial Registry ◽  
Trendelenburg Position ◽  
Pressure Controlled Ventilation ◽  
Pressure Controlled

AbstractThe study aimed to investigate the efficacy of PCV-VG combined with individual PEEP during laparoscopic surgery in the Trendelenburg position. 120 patients were randomly divided into four groups: VF group (VCV plus 5cmH2O PEEP), PF group (PCV-VG plus 5cmH2O PEEP), VI group (VCV plus individual PEEP), and PI group (PCV-VG plus individual PEEP). Pmean, Ppeak, Cdyn, PaO2/FiO2, VD/VT, A-aDO2 and Qs/Qt were recorded at T1 (15 min after the induction of anesthesia), T2 (60 min after pneumoperitoneum), and T3 (5 min at the end of anesthesia). The CC16 and IL-6 were measured at T1 and T3. Our results showed that the Pmean was increased in VI and PI group, and the Ppeak was lower in PI group at T2. At T2 and T3, the Cdyn of PI group was higher than that in other groups, and PaO2/FiO2 was increased in PI group compared with VF and VI group. At T2 and T3, A-aDO2 of PI and PF group was reduced than that in other groups. The Qs/Qt was decreased in PI group compared with VF and VI group at T2 and T3. At T2, VD/VT in PI group was decreased than other groups. At T3, the concentration of CC16 in PI group was lower compared with other groups, and IL-6 level of PI group was decreased than that in VF and VI group. In conclusion, the patients who underwent laparoscopic surgery, PCV-VG combined with individual PEEP produced favorable lung mechanics and oxygenation, and thus reducing inflammatory response and lung injury.Clinical Trial registry: chictr.org. identifier: ChiCTR-2100044928

Respiratory mechanics in mechanically ventilated patients with respiratory failure

1985 ◽  
Vol 58 (6) ◽  
pp. 1849-1858 ◽  
Author(s):  
A. Rossi ◽  
S. B. Gottfried ◽  
B. D. Higgs ◽  
L. Zocchi ◽  
A. Grassino ◽  
...  
Keyword(s):  
Time Constant ◽  
Inflation Rate ◽  
Respiratory Mechanics ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Airway Occlusion ◽  
The Relationship ◽  
Resistance Value ◽  
Ventilated Patients

In 11 mechanically ventilated patients, respiratory mechanics were measured 1) during constant flow inflation and 2) following end-inflation airway occlusion, as proposed in model analysis (J. Appl. Physiol. 58: 1840–1848, 1985. During the latter part of inflation, the relationship between driving pressure and lung volume change was linear, allowing determination of static respiratory elastance (Ers) and resistance (RT). The latter represents in each patient the maximum resistance value that can obtain with the prevailing time constant inhomogeneity. Following occlusion, Ers and RT were also obtained along with RT (min) which represents a minimum, i.e., resistance value that would obtain in the absence of time constant inhomogeneity. A discrepancy between inflation and occlusion Ers and RT was found only in the three patients without positive end-expiratory pressure, and could be attributed to recruitment of lung units during inflation. In all instances Ers and RT were higher than normal. RT(min) was lower in all patients than the corresponding values of RT, indicating that resistance was frequency dependent due to time constant inequalities. Changes in inflation rate did not affect Ers, while RT increased with increasing flow.

scholarly journals Lung Mechanics in Type L CoVID-19 Pneumonia: A Pseudo-Normal ARDS.

2020 ◽  
Author(s):  
Lorenzo Viola ◽  
Emanuele Russo ◽  
Marco Benni ◽  
Emiliano Gamberini ◽  
Alessandro Circelli ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Respiratory System ◽  
Respiratory Mechanics ◽  
Blood Gases ◽  
Lung Mechanics ◽  
Prone Positioning ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Esophageal Balloon ◽  
Early Phases

Abstract Background. This study was conceived to provide systematic data about lung mechanics during early phases of CoVID-19 pneumonia, as long as to explore its variations during prone positioning. Methods. We enrolled four patients hospitalized in the Intensive Care Unit of “M. Bufalini” hospital, Cesena (Italy); after the positioning of an esophageal balloon, we measured mechanical power, respiratory system and transpulmonary parameters and arterial blood gases every 6 hours, just before decubitus change and 1 hour after prono-supination. Results. Both respiratory system and transpulmonary compliance and driving pressure confirmed the pseudo-normal respiratory mechanics of early CoVID-19 pneumonia (respectively, CRS 40.8 ml/cmH2O and DPRS 9.7 cmH2O; CL 53.1 ml/cmH2O and DPL 7.9 cmH2O). Interestingly, prone positioning involved a worsening in respiratory mechanical properties (CRS,SUP 56.3 ml/cmH2O and CRS,PR 41.5 ml/cmH2O – P 0.37; CL,SUP 80.8 ml/cmH2O and CL,PR 53.2 ml/cmH2O – P 0.23). Conclusions. Despite the severe ARDS pattern, respiratory system and lung mechanical properties during CoVID-19 pneumonia are pseudo-normal and tend to worsen during pronation. Trial registration. Restrospectively registered.

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