RESPIRATORY INPUT IMPEDANCE IN ANESTHETIZED PARALYZED PATIENTS

Respiratory impedance (Zrs) was measured between 0.25 and 32 Hz in seven anesthetized and paralyzed patients by applying forced oscillation of low amplitude at the inlet of the endotracheal tube. Effective respiratory resistance (Rrs; in cmH2O·l-1·s) fell sharply from 6.2 ± 2.1 (SD) at 0.25 Hz to 2.3 ± 0.6 at 2 Hz. From then on, Rrs decreased slightly with frequency down to 1.5 ± 0.5 at 32 Hz. Respiratory reactance (Xrs; in cmH2O·l-1·s) was -22.2 ± 5.9 at 0.25 Hz and reached zero at ~14 Hz and 2.3 ± 0.8 at 32 Hz. Effective respiratory elastance (Ers = -2π x frequency x Xrs; in cmH2O/l) was 34.8 ± 9.2 at 0.25 Hz and increased markedly with frequency up to 44.2 ± 8.6 at 2 Hz. We interpreted Zrs data in terms of a T network mechanical model. We represented the proximal branch by central airway resistance and inertance. The shunt pathway accounted for bronchial distensibility and alveolar gas compressibility. The distal branch included a Newtonian resistance component for tissues and peripheral airways and a viscoelastic component for tissues. When the viscoelastic component was represented by a Kelvin body as in the model of Bates et al. (J. Appl. Physiol. 61:873-880, 1986), a good fit was obtained over the entire frequency range, and reasonable values of parameters were estimated. The strong frequency dependence of Rrs and Ers observed below 2 Hz in our anesthetized paralyzed patients could be mainly interpreted in terms of tissue viscoelasticity. Nevertheless, the high Ers we found with low volume excursions suggests that tissues also exhibit plasticlike properties.