Noninvasive Evaluation of Instantaneous Total Mechanical Activity of the Respiratory Muscles During Pressure Support Ventilation
Objective: The measurement of esophageal pressure (Pes) is the conventional method for the evaluation of the forces applied to the respiratory system by the respiratory muscles. As an alternative to Pes measurement, we propose the calculation of the instantaneous net pressure applied by the respirat...
Gespeichert in:
Veröffentlicht in: | Chest 1995-07, Vol.108 (1), p.208-215 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 215 |
---|---|
container_issue | 1 |
container_start_page | 208 |
container_title | Chest |
container_volume | 108 |
creator | Lotti, Giorgio A. Braschi, Antonio Brunner, Josef X. Palo, Alessandra Olivet, Maddalena C. |
description | Objective: The measurement of esophageal pressure (Pes) is the conventional method for the evaluation of the forces applied to the respiratory system by the respiratory muscles. As an alternative to Pes measurement, we propose the calculation of the instantaneous net pressure applied by the respiratory muscles [Pmusc(t)].
Design: Prospective, randomized study.
Setting: A general ICU of a university hospital.
Patients: Eight intubated patients submitted to pressure support ventilation for acute respiratory failure.
Interventions: Four different levels of pressure support were used to unload progressively the respiratory muscles. Pmusc(t) was calculated at all levels of pressure support and compared with Pes corrected for chest wall load as a reference. Pmusc(t) was further used to calculate inspiratory work of breathing, which in turn was compared with data obtained with the conventional method.
Measurements and results: Airway pressure, airflow, and Pes were measured. Both for amplitude and for timing, Pmusc(t) showed good agreement with reference measurements. Work of breathing as calculated from Pmusc(t) agreed well with the measurement obtained with the conventional method (mean difference, 0.057 ± 0.157 J).
Conclusions: Noninvasive evaluation of Pmusc(t) allows extended monitoring of mechanical ventilation, which is particularly interesting for pressure preset ventilation modes. |
doi_str_mv | 10.1378/chest.108.1.208 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_77388553</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0012369216386184</els_id><sourcerecordid>77388553</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-fb8b9730b70133c3a57e6805ef2ceadf4bd97c31ce69dab1dfc6d9d0ce76b8033</originalsourceid><addsrcrecordid>eNp1kM1v1DAQxS0EKtvCmROSD4hbtvY6Xz5WpZRKLSAoXC3HmTSuvHbqj6C98afjbVZVL0iW7NG8eW_8Q-gdJWvKmvZUjRDimpJ2Tdcb0r5AK8oZLVhVspdoRQjdFKzmm9foOIR7kmvK6yN01NSk5jVZob9fndV2lkHPgC9maZKM2lnsBnxlQ5Q2H3Ap4FsXpcE3oEZptcrPMxX1rONuL40j4B8QJu1ldH6Hb1JQBgL-lLy2d_i7hxCSB_wzTZPzEf8GG7V5THqDXg3SBHh7uE_Qr88Xt-dfiutvl1fnZ9eFKimNxdC1HW8Y6RpCGVNMVg3ULalg2CiQ_VB2PW8Uowpq3suO9oOqe94TBU3dtYSxE_Rx8Z28e0gZmtjqoMCY5X-iaVjbVtVeeLoIlXcheBjE5PVW-p2gROyZi0fmuWoFFZl5nnh_sE7dFvon_QFy7n849GXI5AYvrdLhScYqXtLyWfCo78Y_2oMIW2lMNmVL5L1L3krzPJgvE5DBzRq8CEqDVdDnaRVF7_R_l_4HhDOzaw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>77388553</pqid></control><display><type>article</type><title>Noninvasive Evaluation of Instantaneous Total Mechanical Activity of the Respiratory Muscles During Pressure Support Ventilation</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Lotti, Giorgio A. ; Braschi, Antonio ; Brunner, Josef X. ; Palo, Alessandra ; Olivet, Maddalena C.</creator><creatorcontrib>Lotti, Giorgio A. ; Braschi, Antonio ; Brunner, Josef X. ; Palo, Alessandra ; Olivet, Maddalena C.</creatorcontrib><description>Objective: The measurement of esophageal pressure (Pes) is the conventional method for the evaluation of the forces applied to the respiratory system by the respiratory muscles. As an alternative to Pes measurement, we propose the calculation of the instantaneous net pressure applied by the respiratory muscles [Pmusc(t)].
Design: Prospective, randomized study.
Setting: A general ICU of a university hospital.
Patients: Eight intubated patients submitted to pressure support ventilation for acute respiratory failure.
Interventions: Four different levels of pressure support were used to unload progressively the respiratory muscles. Pmusc(t) was calculated at all levels of pressure support and compared with Pes corrected for chest wall load as a reference. Pmusc(t) was further used to calculate inspiratory work of breathing, which in turn was compared with data obtained with the conventional method.
Measurements and results: Airway pressure, airflow, and Pes were measured. Both for amplitude and for timing, Pmusc(t) showed good agreement with reference measurements. Work of breathing as calculated from Pmusc(t) agreed well with the measurement obtained with the conventional method (mean difference, 0.057 ± 0.157 J).
Conclusions: Noninvasive evaluation of Pmusc(t) allows extended monitoring of mechanical ventilation, which is particularly interesting for pressure preset ventilation modes.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.108.1.208</identifier><identifier>PMID: 7606960</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: Elsevier Inc</publisher><subject>acute respiratory failure ; Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Biomechanical Phenomena ; Emergency and intensive respiratory care ; esophageal pressure ; Female ; Humans ; inspiratory muscle activity ; Intensive care medicine ; Male ; mechanical ventilation ; Medical sciences ; Middle Aged ; Monitoring, Physiologic ; pressure support ventilation ; Prospective Studies ; Respiration, Artificial ; Respiratory Insufficiency - physiopathology ; Respiratory Insufficiency - therapy ; Respiratory Mechanics ; respiratory motor output ; respiratory muscles ; Respiratory Muscles - physiopathology ; Work of Breathing</subject><ispartof>Chest, 1995-07, Vol.108 (1), p.208-215</ispartof><rights>1995 The American College of Chest Physicians</rights><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-fb8b9730b70133c3a57e6805ef2ceadf4bd97c31ce69dab1dfc6d9d0ce76b8033</citedby><cites>FETCH-LOGICAL-c411t-fb8b9730b70133c3a57e6805ef2ceadf4bd97c31ce69dab1dfc6d9d0ce76b8033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3594143$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7606960$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lotti, Giorgio A.</creatorcontrib><creatorcontrib>Braschi, Antonio</creatorcontrib><creatorcontrib>Brunner, Josef X.</creatorcontrib><creatorcontrib>Palo, Alessandra</creatorcontrib><creatorcontrib>Olivet, Maddalena C.</creatorcontrib><title>Noninvasive Evaluation of Instantaneous Total Mechanical Activity of the Respiratory Muscles During Pressure Support Ventilation</title><title>Chest</title><addtitle>Chest</addtitle><description>Objective: The measurement of esophageal pressure (Pes) is the conventional method for the evaluation of the forces applied to the respiratory system by the respiratory muscles. As an alternative to Pes measurement, we propose the calculation of the instantaneous net pressure applied by the respiratory muscles [Pmusc(t)].
Design: Prospective, randomized study.
Setting: A general ICU of a university hospital.
Patients: Eight intubated patients submitted to pressure support ventilation for acute respiratory failure.
Interventions: Four different levels of pressure support were used to unload progressively the respiratory muscles. Pmusc(t) was calculated at all levels of pressure support and compared with Pes corrected for chest wall load as a reference. Pmusc(t) was further used to calculate inspiratory work of breathing, which in turn was compared with data obtained with the conventional method.
Measurements and results: Airway pressure, airflow, and Pes were measured. Both for amplitude and for timing, Pmusc(t) showed good agreement with reference measurements. Work of breathing as calculated from Pmusc(t) agreed well with the measurement obtained with the conventional method (mean difference, 0.057 ± 0.157 J).
Conclusions: Noninvasive evaluation of Pmusc(t) allows extended monitoring of mechanical ventilation, which is particularly interesting for pressure preset ventilation modes.</description><subject>acute respiratory failure</subject><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Biomechanical Phenomena</subject><subject>Emergency and intensive respiratory care</subject><subject>esophageal pressure</subject><subject>Female</subject><subject>Humans</subject><subject>inspiratory muscle activity</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>mechanical ventilation</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Monitoring, Physiologic</subject><subject>pressure support ventilation</subject><subject>Prospective Studies</subject><subject>Respiration, Artificial</subject><subject>Respiratory Insufficiency - physiopathology</subject><subject>Respiratory Insufficiency - therapy</subject><subject>Respiratory Mechanics</subject><subject>respiratory motor output</subject><subject>respiratory muscles</subject><subject>Respiratory Muscles - physiopathology</subject><subject>Work of Breathing</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1v1DAQxS0EKtvCmROSD4hbtvY6Xz5WpZRKLSAoXC3HmTSuvHbqj6C98afjbVZVL0iW7NG8eW_8Q-gdJWvKmvZUjRDimpJ2Tdcb0r5AK8oZLVhVspdoRQjdFKzmm9foOIR7kmvK6yN01NSk5jVZob9fndV2lkHPgC9maZKM2lnsBnxlQ5Q2H3Ap4FsXpcE3oEZptcrPMxX1rONuL40j4B8QJu1ldH6Hb1JQBgL-lLy2d_i7hxCSB_wzTZPzEf8GG7V5THqDXg3SBHh7uE_Qr88Xt-dfiutvl1fnZ9eFKimNxdC1HW8Y6RpCGVNMVg3ULalg2CiQ_VB2PW8Uowpq3suO9oOqe94TBU3dtYSxE_Rx8Z28e0gZmtjqoMCY5X-iaVjbVtVeeLoIlXcheBjE5PVW-p2gROyZi0fmuWoFFZl5nnh_sE7dFvon_QFy7n849GXI5AYvrdLhScYqXtLyWfCo78Y_2oMIW2lMNmVL5L1L3krzPJgvE5DBzRq8CEqDVdDnaRVF7_R_l_4HhDOzaw</recordid><startdate>19950701</startdate><enddate>19950701</enddate><creator>Lotti, Giorgio A.</creator><creator>Braschi, Antonio</creator><creator>Brunner, Josef X.</creator><creator>Palo, Alessandra</creator><creator>Olivet, Maddalena C.</creator><general>Elsevier Inc</general><general>American College of Chest Physicians</general><scope>IQODW</scope><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>19950701</creationdate><title>Noninvasive Evaluation of Instantaneous Total Mechanical Activity of the Respiratory Muscles During Pressure Support Ventilation</title><author>Lotti, Giorgio A. ; Braschi, Antonio ; Brunner, Josef X. ; Palo, Alessandra ; Olivet, Maddalena C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-fb8b9730b70133c3a57e6805ef2ceadf4bd97c31ce69dab1dfc6d9d0ce76b8033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>acute respiratory failure</topic><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Biomechanical Phenomena</topic><topic>Emergency and intensive respiratory care</topic><topic>esophageal pressure</topic><topic>Female</topic><topic>Humans</topic><topic>inspiratory muscle activity</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>mechanical ventilation</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Monitoring, Physiologic</topic><topic>pressure support ventilation</topic><topic>Prospective Studies</topic><topic>Respiration, Artificial</topic><topic>Respiratory Insufficiency - physiopathology</topic><topic>Respiratory Insufficiency - therapy</topic><topic>Respiratory Mechanics</topic><topic>respiratory motor output</topic><topic>respiratory muscles</topic><topic>Respiratory Muscles - physiopathology</topic><topic>Work of Breathing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lotti, Giorgio A.</creatorcontrib><creatorcontrib>Braschi, Antonio</creatorcontrib><creatorcontrib>Brunner, Josef X.</creatorcontrib><creatorcontrib>Palo, Alessandra</creatorcontrib><creatorcontrib>Olivet, Maddalena C.</creatorcontrib><collection>Pascal-Francis</collection><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>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lotti, Giorgio A.</au><au>Braschi, Antonio</au><au>Brunner, Josef X.</au><au>Palo, Alessandra</au><au>Olivet, Maddalena C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Noninvasive Evaluation of Instantaneous Total Mechanical Activity of the Respiratory Muscles During Pressure Support Ventilation</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>1995-07-01</date><risdate>1995</risdate><volume>108</volume><issue>1</issue><spage>208</spage><epage>215</epage><pages>208-215</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>Objective: The measurement of esophageal pressure (Pes) is the conventional method for the evaluation of the forces applied to the respiratory system by the respiratory muscles. As an alternative to Pes measurement, we propose the calculation of the instantaneous net pressure applied by the respiratory muscles [Pmusc(t)].
Design: Prospective, randomized study.
Setting: A general ICU of a university hospital.
Patients: Eight intubated patients submitted to pressure support ventilation for acute respiratory failure.
Interventions: Four different levels of pressure support were used to unload progressively the respiratory muscles. Pmusc(t) was calculated at all levels of pressure support and compared with Pes corrected for chest wall load as a reference. Pmusc(t) was further used to calculate inspiratory work of breathing, which in turn was compared with data obtained with the conventional method.
Measurements and results: Airway pressure, airflow, and Pes were measured. Both for amplitude and for timing, Pmusc(t) showed good agreement with reference measurements. Work of breathing as calculated from Pmusc(t) agreed well with the measurement obtained with the conventional method (mean difference, 0.057 ± 0.157 J).
Conclusions: Noninvasive evaluation of Pmusc(t) allows extended monitoring of mechanical ventilation, which is particularly interesting for pressure preset ventilation modes.</abstract><cop>Northbrook, IL</cop><pub>Elsevier Inc</pub><pmid>7606960</pmid><doi>10.1378/chest.108.1.208</doi><tpages>8</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0012-3692 |
ispartof | Chest, 1995-07, Vol.108 (1), p.208-215 |
issn | 0012-3692 1931-3543 |
language | eng |
recordid | cdi_proquest_miscellaneous_77388553 |
source | MEDLINE; Alma/SFX Local Collection |
subjects | acute respiratory failure Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Biomechanical Phenomena Emergency and intensive respiratory care esophageal pressure Female Humans inspiratory muscle activity Intensive care medicine Male mechanical ventilation Medical sciences Middle Aged Monitoring, Physiologic pressure support ventilation Prospective Studies Respiration, Artificial Respiratory Insufficiency - physiopathology Respiratory Insufficiency - therapy Respiratory Mechanics respiratory motor output respiratory muscles Respiratory Muscles - physiopathology Work of Breathing |
title | Noninvasive Evaluation of Instantaneous Total Mechanical Activity of the Respiratory Muscles During Pressure Support Ventilation |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T17%3A15%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Noninvasive%20Evaluation%20of%20Instantaneous%20Total%20Mechanical%20Activity%20of%20the%20Respiratory%20Muscles%20During%20Pressure%20Support%20Ventilation&rft.jtitle=Chest&rft.au=Lotti,%20Giorgio%20A.&rft.date=1995-07-01&rft.volume=108&rft.issue=1&rft.spage=208&rft.epage=215&rft.pages=208-215&rft.issn=0012-3692&rft.eissn=1931-3543&rft.coden=CHETBF&rft_id=info:doi/10.1378/chest.108.1.208&rft_dat=%3Cproquest_cross%3E77388553%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=77388553&rft_id=info:pmid/7606960&rft_els_id=S0012369216386184&rfr_iscdi=true |