Effects of a sigh on the respiratory mechanical properties in ALI patients

被引：4

作者：

Antonaglia V. ^{[1
]}

Pascotto S. ^{[1
]}

De Simoni L. ^{[1
]}

Zin W.A. ^{[2
]}

机构：

[1] Istituto di Anestesia, Rianimazione e Terapia Antalgica, Laboratorio di Biomeccanica Respiratoria, Università degli Studi di Trieste, I-34139 Trieste

[2] Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro

来源：

J. Clin. Monit. Comput. | 2006年 / 4卷 / 243-249期

关键词：

Critical care; Elastance; Resistance; Respiratory mechanics; Sigh;

D O I：

10.1007/s10877-006-9028-x

中图分类号：

学科分类号：

摘要：

Objectives. The applicat ion of sighs during baseline ventilation was found to improve alveolar recruitment and oxygenation in patients with acute respiratory distress syndrome (ARDS). The present investigation evaluates if respiratory mechanics can be modified by a sigh. Methods. Ten consecutive patients with acute lung injury (ALI) admitted to the University Hospital Intensive Care Unit the were studied during mechanical ventilation. Three sighs were administered to sedated-paralyzed patients during the measurement period. Respiratory mechanics were studi ed in regular breaths immediately before and after a sigh provided that a steady-state had been reached and by the airway pressure-time curve profile to evaluate the lung recruitment. Viscoelastic constants (elastic, resistive, and time), as well as elastance and resistances, were determined by the single breath method. Arterial blood gases were also determined pre- and post-sigh. Results. Elastic and resistive components of viscoelasticity decreased after a sigh (20 and 21%, respectively). As a result, the pressure required to overcome viscoelasticity and mechanical inhomogeneities also decreased in these patients (17%). The mechanical changes were associated with alterations in PaO2. Conclusions. The sigh is useful to diminish viscoelastic impedance in ALI patients, thus allowing a smaller inflation pressure. Under the present experimental conditions it seems that viscoelastic mechanical alterations precede their elastic and resistive counterparts. © Springer Science+Business Media, Inc. 2006.

引用

页码：243 / 249

页数：6

共 26 条

[11]

Ranieri V.M., Giuliani R., Fiore T., Dambrosio M., Milic-Emili J., Volume-pressure curve of the respiratory system predicts effects of PEEP in ARDS: "Occlusion" versus "Constant flow" Technique, Am J Respir Crit Care Med, 149, pp. 19-27, (1994)

[12]

Antonaglia V., Grop A., Demanins P., Beltrame F., Lucangelo U., Peratoner A., De Simoni L., Gullo A., Milic-Emili J., Single-breath method for assessing the viscoelastic properties of the respiratory system, Eur Respir J, 12, pp. 1191-1196, (1998)

[13]

Beydon L., Svantesson C., Brauer K., Lemaire F., Jonson B., Respiratory mechanics in patients ventilated for critical lung disease, Eur Respir J, 9, pp. 262-273, (1996)

[14]

Bates J.H.T., Hunter I.W., Sly P.D., Okubo S., Filiatrault S., Milic-Emili J., Effect of valve closure time on the determination of respiratory of respiratory resistance by flow interruption, Med Biol Eng Comput, 25, pp. 136-140, (1987)

[15]

Neumann P., Berglund J.E., Fernandez Mondejar E., Magnusson A., Hedenstierna G., Dynamics of lung collapse and recruitment during prolonged breathingin porcine lung injury, J Appl Physiol, 85, pp. 1533-1543, (1998)

[16]

Suki B., Bates J.H.T., A non linear viscoelastic model of lung tissue mechanics, J Appl Physiol, 71, pp. 826-833, (1991)

[17]

Hildebrandt J., Pressure-volume data of cat lung interpreted by a plastoelastic linear viscoelastic model, J Appl Physiol, 28, pp. 365-372, (1970)

[18]

D'Angelo E., Calderini E., Torri G., Robatto F.M., Bono D., Milic-Emili J., Respiratory mechanics in anesthetized paralyzed humans: Effects of flow, volume, and time, J Appl Physiol, 67, pp. 2556-2564, (1989)

[19]

D'Angelo E., Tavola M., Milic-Emili J., Volume and time dependence of respiratory system mechanics in normal anaesthetized paralysed humans, Eur Respir J, 16, pp. 665-672, (2000)

[20]

Antonaglia V., Peratoner A., De Simoni L., Gullo A., Milic-Emili J., Zin W., Bedside assessment of respiratory viscoelastic properties in ventilated patients, Eur Respir J, 16, pp. 302-308, (2000)

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