Dataset Information
Continuous monitoring of intrinsic PEEP based on expired CO2 kinetics: an experimental validation study.
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ABSTRACT: Background
Quantification of intrinsic PEEP (PEEPi) has important implications for patients subjected to invasive mechanical ventilation. A new non-invasive breath-by-breath method (etCO2D) for determination of PEEPi is evaluated.Methods
In 12 mechanically ventilated pigs, dynamic hyperinflation was induced by interposing a resistance in the endotracheal tube. Airway pressure, flow, and exhaled CO2 were measured at the airway opening. Combining different I:E ratios, respiratory rates, and tidal volumes, 52 different levels of PEEPi (range 1.8-11.7 cmH2O; mean 8.45?±?0.32 cmH2O) were studied. The etCO2D is based on the detection of the end-tidal dilution of the capnogram. This is measured at the airway opening by means of a CO2 sensor in which a 2-mm leak is added to the sensing chamber. This allows to detect a capnogram dilution with fresh air when the pressure coming from the ventilator exceeds the PEEPi. This method was compared with the occlusion method.Results
The etCO2D method detected PEEPi step changes of 0.2 cmH2O. Reference and etCO2D PEEPi presented a good correlation (R2 0.80, P?ConclusionsThe etCO2D method is a promising accurate simple way of continuously measure and monitor PEEPi. Its clinical validity needs, however, to be confirmed in clinical studies and in conditions with heterogeneous lung diseases.
SUBMITTER: Heili-Frades S
PROVIDER: S-EPMC6540388 | biostudies-literature | 2019 May
REPOSITORIES: biostudies-literature
Publications
Continuous monitoring of intrinsic PEEP based on expired CO<sub>2</sub> kinetics: an experimental validation study.
Critical care (London, England) 20190529 1
<h4>Background</h4>Quantification of intrinsic PEEP (PEEPi) has important implications for patients subjected to invasive mechanical ventilation. A new non-invasive breath-by-breath method (etCO<sub>2</sub>D) for determination of PEEPi is evaluated.<h4>Methods</h4>In 12 mechanically ventilated pigs, dynamic hyperinflation was induced by interposing a resistance in the endotracheal tube. Airway pressure, flow, and exhaled CO<sub>2</sub> were measured at the airway opening. Combining different I:E ...[more]