A NEW METHOD FOR P0.1 MEASUREMENT USING STANDARD RESPIRATORY EQUIPMENT

被引:39
作者
KUHLEN, R
HAUSMANN, S
PAPPERT, D
SLAMA, K
ROSSAINT, R
FALKE, K
机构
[1] Department of Anesthesiology and Operative Intensive Care Medicine, University Clinic Rudolf Virchow, Free University, Berlin, D-13344
关键词
AIRWAY OCCLUSION PRESSURE; MECHANICAL VENTILATION; WEANING; RESPIRATOR TECHNOLOGY;
D O I
10.1007/BF01700159
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The airway occlusion pressure, P0.1, is an index for the neuro-muscular activation of the respiratory system. It has been shown to be a very useful indicator for the ability of patients receiving ventilatory support to be weaned from mechanical ventilation. Since the standard measurement technique for P 0.1 determination is technically complex, it is not widely available for clinical purposes. For that reason a P 0.1 measurement technique was developed as an integrated function in a standard respirator (Evita, Drager, Lubeck, Germany). This technique is easy to use and does not need any further equipment. We validated this new technique by comparing it to standard P0.1 measurements in a mechanical lung model as well as in ventilated patients. In the lung model we found a correlation between the Evita measurement and standard measurements of r = 0.99. In 6 ventilated patients the correlation was r = 0.78. Since the Evita P0.1 and the standard measurement had to be performed during two different breaths, this little poorer correlation in patients may be due to a significant breath-by-breath variability in P0.1. Comparing the Evita P0.1 and the standard measurement within one breath resulted in a clearly better correlation (r = 0.89). We conclude that this new measurement technique provides an easy and accurate P0.1 measurement using standard respiratory equipment when tested in a lung model. In patient measurements the method is less precise, which is probably due to the variable waveforms of the inspiratory driving pressure seen in patients, for example when intrinsic PEEP is present. However, the new method makes the P0.1 measurement as a ''bed-side'' method clinically available, although the values should be interpreted cautiously.
引用
收藏
页码:554 / 560
页数:7
相关论文
共 13 条
[1]   STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT [J].
BLAND, JM ;
ALTMAN, DG .
LANCET, 1986, 1 (8476) :307-310
[2]  
CALBUSERA J, 1993, AM REV RESPIR DIS, V147, pA876
[3]   RELATIONSHIP OF THORACIC VOLUME AND AIRWAY OCCLUSION PRESSURE - MUSCULAR EFFECTS [J].
ELDRIDGE, FL ;
VAUGHN, KZ .
JOURNAL OF APPLIED PHYSIOLOGY, 1977, 43 (02) :312-321
[4]   P0.1 PIMAX - AN INDEX FOR ASSESSING RESPIRATORY CAPACITY IN ACUTE RESPIRATORY-FAILURE [J].
FERNANDEZ, R ;
CABRERA, J ;
CALAF, N ;
BENITO, S .
INTENSIVE CARE MEDICINE, 1990, 16 (03) :175-179
[5]   EVALUATION OF INDEXES PREDICTING THE OUTCOME OF VENTILATOR WEANING AND VALUE OF ADDING SUPPLEMENTAL INSPIRATORY LOAD [J].
GANDIA, F ;
BLANCO, J .
INTENSIVE CARE MEDICINE, 1992, 18 (06) :327-333
[6]   CONTROL OF TIDAL VOLUME AND RESPIRATORY FREQUENCY IN ANESTHETIZED CATS [J].
GRUNSTEI.MM ;
YOUNES, M ;
MILICEMI.J .
JOURNAL OF APPLIED PHYSIOLOGY, 1973, 35 (04) :463-476
[7]  
HERRERA M, 1985, INTENS CARE MED, V11, P134
[8]   BREATH-BY-BREATH DETERMINATION OF INSPIRATORY OCCLUSION PRESSURE [J].
LARSSON, H ;
HELLSTROM, LG ;
LINNARSSON, D .
CLINICAL PHYSIOLOGY, 1993, 13 (02) :133-142
[9]   THE INSPIRATORY WORKLOAD OF PATIENT-INITIATED MECHANICAL VENTILATION [J].
MARINI, JJ ;
RODRIGUEZ, RM ;
LAMB, V .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1986, 134 (05) :902-909
[10]   TRACHEAL OCCLUSION PRESSURE - A SIMPLE INDEX TO MONITOR RESPIRATORY MUSCLE FATIGUE DURING ACUTE RESPIRATORY-FAILURE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE [J].
MURCIANO, D ;
BOCZKOWSKI, J ;
LECOCGUIC, Y ;
EMILI, JM ;
PARIENTE, R ;
AUBIER, M .
ANNALS OF INTERNAL MEDICINE, 1988, 108 (06) :800-805