Optimal mean airway pressure during high-frequency oscillatory ventilation determined by measurement of respiratory system reactance
Background: The aims of the present study were (i) to characterize the relationship between mean airway pressure ( P AW ) and reactance measured at 5 Hz (reactance of the respiratory system ( X RS ) , forced oscillation technique) and (ii) to compare optimal P AW ( P opt ) defined by X RS , oxygenat...
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| Veröffentlicht in: | Pediatric research 2014-04, Vol.75 (4), p.493-499 |
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| creator | Zannin, Emanuela Ventura, Maria Luisa Dellacà, Raffaele L. Natile, Miria Tagliabue, Paolo Perkins, Elizabeth J. Sourial, Magdy Bhatia, Risha Dargaville, Peter A. Tingay, David G. |
| description | Background:
The aims of the present study were (i) to characterize the relationship between mean airway pressure (
P
AW
) and reactance measured at 5 Hz (reactance of the respiratory system (
X
RS
)
,
forced oscillation technique) and (ii) to compare optimal
P
AW
(
P
opt
) defined by
X
RS
, oxygenation, lung volume (
V
L
), and tidal volume (
V
T
) in preterm lambs receiving high-frequency oscillatory ventilation (HFOV).
Methods:
Nine 132-d gestation lambs were commenced on HFOV at
P
AW
of 14 cmH
2
O (
P
start
).
P
AW
was increased stepwise to a maximum pressure (
P
max
) and subsequently sequentially decreased to the closing pressure (
P
cl
, oxygenation deteriorated) or a minimum of 6 cmH
2
O, using an oxygenation-based recruitment maneuver.
X
RS
, regional
V
L
(electrical impedance tomography), and
V
T
were measured immediately after (
t
0min
) and 2 min after (
t
2min
) each
P
AW
decrement.
P
opt
defined by oxygenation,
X
RS
,
V
L
, and
V
T
were determined.
Results:
The
P
AW
–
X
RS
and
P
AW
–
V
T
relationships were dome shaped with a maximum at
P
cl
+6 cmH
2
O, the same point as
P
opt
defined by
V
L
. Below
P
cl
+6 cmH
2
O,
X
RS
became unstable between
t
0min
and
t
2min
and was associated with derecruitment in the dependent lung.
P
opt
, as defined by oxygenation, was lower than the
P
opt
defined by
X
RS
,
V
L
, or
V
T
.
Conclusion:
X
RS
has the potential as a bedside tool for optimizing
P
AW
during HFOV. |
| doi_str_mv | 10.1038/pr.2013.251 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1508946440</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1508946440</sourcerecordid><originalsourceid>FETCH-LOGICAL-c363t-ed3c659daeb5b0d8cbd99deba6ff5f02f92bfb6aff24247ae0c0fb54ddeb60653</originalsourceid><addsrcrecordid>eNptkE1r3DAQQEVo6G63PeVedCyk3o4syWsfy5KkgUAuydnoY5RoWcuuZDf4nh8emU176knS8PRgHiEXDLYMeP1jiNsSGN-Wkp2RNZMcChBi94GsATgreNPUK_IppQMAE7IWH8mqFHwnoa7W5PV-GH2njrRDFajy8UXNdIiY0hSR2in68ESf_dNz4SL-njCYmfbJ-ONRjX2c6R8Mo8933wdqccTY-YCW6nkRLo4uA7R3NCsHH0-f0pxG7PJImVEFg5_JuVPHhF_ezw15vL562P8q7u5vbvc_7wrDKz4WaLmpZGMVaqnB1kbbprGoVeWcdFC6ptROV8q5UpRipxAMOC2FzUwFleQb8u3kHWKfd0lj2_lkMO8SsJ9Sy3KTRlRCQEYvT6iJfUoRXTvE3CnOLYN2yZ7f7ZK9zdkz_fVdPOkO7T_2b-cMfD8BaViKYmwP_RRDXva_vjdMp5IZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1508946440</pqid></control><display><type>article</type><title>Optimal mean airway pressure during high-frequency oscillatory ventilation determined by measurement of respiratory system reactance</title><source>MEDLINE</source><source>Springer Nature Link eJournals</source><source>Alma/SFX Local Collection</source><source>EZB Electronic Journals Library</source><creator>Zannin, Emanuela ; Ventura, Maria Luisa ; Dellacà, Raffaele L. ; Natile, Miria ; Tagliabue, Paolo ; Perkins, Elizabeth J. ; Sourial, Magdy ; Bhatia, Risha ; Dargaville, Peter A. ; Tingay, David G.</creator><creatorcontrib>Zannin, Emanuela ; Ventura, Maria Luisa ; Dellacà, Raffaele L. ; Natile, Miria ; Tagliabue, Paolo ; Perkins, Elizabeth J. ; Sourial, Magdy ; Bhatia, Risha ; Dargaville, Peter A. ; Tingay, David G.</creatorcontrib><description>Background:
The aims of the present study were (i) to characterize the relationship between mean airway pressure (
P
AW
) and reactance measured at 5 Hz (reactance of the respiratory system (
X
RS
)
,
forced oscillation technique) and (ii) to compare optimal
P
AW
(
P
opt
) defined by
X
RS
, oxygenation, lung volume (
V
L
), and tidal volume (
V
T
) in preterm lambs receiving high-frequency oscillatory ventilation (HFOV).
Methods:
Nine 132-d gestation lambs were commenced on HFOV at
P
AW
of 14 cmH
2
O (
P
start
).
P
AW
was increased stepwise to a maximum pressure (
P
max
) and subsequently sequentially decreased to the closing pressure (
P
cl
, oxygenation deteriorated) or a minimum of 6 cmH
2
O, using an oxygenation-based recruitment maneuver.
X
RS
, regional
V
L
(electrical impedance tomography), and
V
T
were measured immediately after (
t
0min
) and 2 min after (
t
2min
) each
P
AW
decrement.
P
opt
defined by oxygenation,
X
RS
,
V
L
, and
V
T
were determined.
Results:
The
P
AW
–
X
RS
and
P
AW
–
V
T
relationships were dome shaped with a maximum at
P
cl
+6 cmH
2
O, the same point as
P
opt
defined by
V
L
. Below
P
cl
+6 cmH
2
O,
X
RS
became unstable between
t
0min
and
t
2min
and was associated with derecruitment in the dependent lung.
P
opt
, as defined by oxygenation, was lower than the
P
opt
defined by
X
RS
,
V
L
, or
V
T
.
Conclusion:
X
RS
has the potential as a bedside tool for optimizing
P
AW
during HFOV.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/pr.2013.251</identifier><identifier>PMID: 24375086</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>631/443/1784 ; 692/700/1720 ; Animals ; basic-science-investigation ; Female ; High-Frequency Ventilation - methods ; Male ; Medicine & Public Health ; Oxygen - metabolism ; Pediatric Surgery ; Pediatrics ; Pressure ; Sheep ; Trachea - physiology</subject><ispartof>Pediatric research, 2014-04, Vol.75 (4), p.493-499</ispartof><rights>International Pediatric Research Foundation, Inc. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c363t-ed3c659daeb5b0d8cbd99deba6ff5f02f92bfb6aff24247ae0c0fb54ddeb60653</citedby><cites>FETCH-LOGICAL-c363t-ed3c659daeb5b0d8cbd99deba6ff5f02f92bfb6aff24247ae0c0fb54ddeb60653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/pr.2013.251$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/pr.2013.251$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24375086$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zannin, Emanuela</creatorcontrib><creatorcontrib>Ventura, Maria Luisa</creatorcontrib><creatorcontrib>Dellacà, Raffaele L.</creatorcontrib><creatorcontrib>Natile, Miria</creatorcontrib><creatorcontrib>Tagliabue, Paolo</creatorcontrib><creatorcontrib>Perkins, Elizabeth J.</creatorcontrib><creatorcontrib>Sourial, Magdy</creatorcontrib><creatorcontrib>Bhatia, Risha</creatorcontrib><creatorcontrib>Dargaville, Peter A.</creatorcontrib><creatorcontrib>Tingay, David G.</creatorcontrib><title>Optimal mean airway pressure during high-frequency oscillatory ventilation determined by measurement of respiratory system reactance</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>Background:
The aims of the present study were (i) to characterize the relationship between mean airway pressure (
P
AW
) and reactance measured at 5 Hz (reactance of the respiratory system (
X
RS
)
,
forced oscillation technique) and (ii) to compare optimal
P
AW
(
P
opt
) defined by
X
RS
, oxygenation, lung volume (
V
L
), and tidal volume (
V
T
) in preterm lambs receiving high-frequency oscillatory ventilation (HFOV).
Methods:
Nine 132-d gestation lambs were commenced on HFOV at
P
AW
of 14 cmH
2
O (
P
start
).
P
AW
was increased stepwise to a maximum pressure (
P
max
) and subsequently sequentially decreased to the closing pressure (
P
cl
, oxygenation deteriorated) or a minimum of 6 cmH
2
O, using an oxygenation-based recruitment maneuver.
X
RS
, regional
V
L
(electrical impedance tomography), and
V
T
were measured immediately after (
t
0min
) and 2 min after (
t
2min
) each
P
AW
decrement.
P
opt
defined by oxygenation,
X
RS
,
V
L
, and
V
T
were determined.
Results:
The
P
AW
–
X
RS
and
P
AW
–
V
T
relationships were dome shaped with a maximum at
P
cl
+6 cmH
2
O, the same point as
P
opt
defined by
V
L
. Below
P
cl
+6 cmH
2
O,
X
RS
became unstable between
t
0min
and
t
2min
and was associated with derecruitment in the dependent lung.
P
opt
, as defined by oxygenation, was lower than the
P
opt
defined by
X
RS
,
V
L
, or
V
T
.
Conclusion:
X
RS
has the potential as a bedside tool for optimizing
P
AW
during HFOV.</description><subject>631/443/1784</subject><subject>692/700/1720</subject><subject>Animals</subject><subject>basic-science-investigation</subject><subject>Female</subject><subject>High-Frequency Ventilation - methods</subject><subject>Male</subject><subject>Medicine & Public Health</subject><subject>Oxygen - metabolism</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Pressure</subject><subject>Sheep</subject><subject>Trachea - physiology</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkE1r3DAQQEVo6G63PeVedCyk3o4syWsfy5KkgUAuydnoY5RoWcuuZDf4nh8emU176knS8PRgHiEXDLYMeP1jiNsSGN-Wkp2RNZMcChBi94GsATgreNPUK_IppQMAE7IWH8mqFHwnoa7W5PV-GH2njrRDFajy8UXNdIiY0hSR2in68ESf_dNz4SL-njCYmfbJ-ONRjX2c6R8Mo8933wdqccTY-YCW6nkRLo4uA7R3NCsHH0-f0pxG7PJImVEFg5_JuVPHhF_ezw15vL562P8q7u5vbvc_7wrDKz4WaLmpZGMVaqnB1kbbprGoVeWcdFC6ptROV8q5UpRipxAMOC2FzUwFleQb8u3kHWKfd0lj2_lkMO8SsJ9Sy3KTRlRCQEYvT6iJfUoRXTvE3CnOLYN2yZ7f7ZK9zdkz_fVdPOkO7T_2b-cMfD8BaViKYmwP_RRDXva_vjdMp5IZ</recordid><startdate>20140401</startdate><enddate>20140401</enddate><creator>Zannin, Emanuela</creator><creator>Ventura, Maria Luisa</creator><creator>Dellacà, Raffaele L.</creator><creator>Natile, Miria</creator><creator>Tagliabue, Paolo</creator><creator>Perkins, Elizabeth J.</creator><creator>Sourial, Magdy</creator><creator>Bhatia, Risha</creator><creator>Dargaville, Peter A.</creator><creator>Tingay, David G.</creator><general>Nature Publishing Group US</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140401</creationdate><title>Optimal mean airway pressure during high-frequency oscillatory ventilation determined by measurement of respiratory system reactance</title><author>Zannin, Emanuela ; Ventura, Maria Luisa ; Dellacà, Raffaele L. ; Natile, Miria ; Tagliabue, Paolo ; Perkins, Elizabeth J. ; Sourial, Magdy ; Bhatia, Risha ; Dargaville, Peter A. ; Tingay, David G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c363t-ed3c659daeb5b0d8cbd99deba6ff5f02f92bfb6aff24247ae0c0fb54ddeb60653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>631/443/1784</topic><topic>692/700/1720</topic><topic>Animals</topic><topic>basic-science-investigation</topic><topic>Female</topic><topic>High-Frequency Ventilation - methods</topic><topic>Male</topic><topic>Medicine & Public Health</topic><topic>Oxygen - metabolism</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Pressure</topic><topic>Sheep</topic><topic>Trachea - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zannin, Emanuela</creatorcontrib><creatorcontrib>Ventura, Maria Luisa</creatorcontrib><creatorcontrib>Dellacà, Raffaele L.</creatorcontrib><creatorcontrib>Natile, Miria</creatorcontrib><creatorcontrib>Tagliabue, Paolo</creatorcontrib><creatorcontrib>Perkins, Elizabeth J.</creatorcontrib><creatorcontrib>Sourial, Magdy</creatorcontrib><creatorcontrib>Bhatia, Risha</creatorcontrib><creatorcontrib>Dargaville, Peter A.</creatorcontrib><creatorcontrib>Tingay, David G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zannin, Emanuela</au><au>Ventura, Maria Luisa</au><au>Dellacà, Raffaele L.</au><au>Natile, Miria</au><au>Tagliabue, Paolo</au><au>Perkins, Elizabeth J.</au><au>Sourial, Magdy</au><au>Bhatia, Risha</au><au>Dargaville, Peter A.</au><au>Tingay, David G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal mean airway pressure during high-frequency oscillatory ventilation determined by measurement of respiratory system reactance</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><addtitle>Pediatr Res</addtitle><date>2014-04-01</date><risdate>2014</risdate><volume>75</volume><issue>4</issue><spage>493</spage><epage>499</epage><pages>493-499</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>Background:
The aims of the present study were (i) to characterize the relationship between mean airway pressure (
P
AW
) and reactance measured at 5 Hz (reactance of the respiratory system (
X
RS
)
,
forced oscillation technique) and (ii) to compare optimal
P
AW
(
P
opt
) defined by
X
RS
, oxygenation, lung volume (
V
L
), and tidal volume (
V
T
) in preterm lambs receiving high-frequency oscillatory ventilation (HFOV).
Methods:
Nine 132-d gestation lambs were commenced on HFOV at
P
AW
of 14 cmH
2
O (
P
start
).
P
AW
was increased stepwise to a maximum pressure (
P
max
) and subsequently sequentially decreased to the closing pressure (
P
cl
, oxygenation deteriorated) or a minimum of 6 cmH
2
O, using an oxygenation-based recruitment maneuver.
X
RS
, regional
V
L
(electrical impedance tomography), and
V
T
were measured immediately after (
t
0min
) and 2 min after (
t
2min
) each
P
AW
decrement.
P
opt
defined by oxygenation,
X
RS
,
V
L
, and
V
T
were determined.
Results:
The
P
AW
–
X
RS
and
P
AW
–
V
T
relationships were dome shaped with a maximum at
P
cl
+6 cmH
2
O, the same point as
P
opt
defined by
V
L
. Below
P
cl
+6 cmH
2
O,
X
RS
became unstable between
t
0min
and
t
2min
and was associated with derecruitment in the dependent lung.
P
opt
, as defined by oxygenation, was lower than the
P
opt
defined by
X
RS
,
V
L
, or
V
T
.
Conclusion:
X
RS
has the potential as a bedside tool for optimizing
P
AW
during HFOV.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>24375086</pmid><doi>10.1038/pr.2013.251</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-3998 |
| ispartof | Pediatric research, 2014-04, Vol.75 (4), p.493-499 |
| issn | 0031-3998 1530-0447 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1508946440 |
| source | MEDLINE; Springer Nature Link eJournals; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | 631/443/1784 692/700/1720 Animals basic-science-investigation Female High-Frequency Ventilation - methods Male Medicine & Public Health Oxygen - metabolism Pediatric Surgery Pediatrics Pressure Sheep Trachea - physiology |
| title | Optimal mean airway pressure during high-frequency oscillatory ventilation determined by measurement of respiratory system reactance |
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