Respiratory mechanics in patients ventilated for critical lung disease

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Respiratory mechanics in patients ventilated for critical lung disease. / Beydon, L; Svantesson, C; Brauer, K; Lemaire, Francois; Jonson, B.

In: European Respiratory Journal, Vol. 9, No. 2, 02.1996, p. 262-73.

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Beydon, L ; Svantesson, C ; Brauer, K ; Lemaire, Francois ; Jonson, B. / Respiratory mechanics in patients ventilated for critical lung disease. In: European Respiratory Journal. 1996 ; Vol. 9, No. 2. pp. 262-73.

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TY - JOUR

T1 - Respiratory mechanics in patients ventilated for critical lung disease

AU - Beydon, L

AU - Svantesson, C

AU - Brauer, K

AU - Lemaire, Francois

AU - Jonson, B

PY - 1996/2

Y1 - 1996/2

N2 - Respiratory mechanics, using flow interruption, was previously studied during the complete breath in healthy ventilated man, numerical techniques relieving constraints regarding flow pattern. The classical linear model of non-Newtonian behaviour was found to be valid. The present study was extended to subjects with critical lung disease. Subjects with acute lung injury (ALI; n = 2), acute respiratory distress syndrome (ARDS; n = 4), and chronic obstructive pulmonary disease (COPD; n = 3) were studied with and without positive end-expiratory pressure (PEEP). Functional residual capacity (FRC) was measured with sulphur hexafluoride (SF6) wash-out. The static pressure-volume (P-V) curve was linear at zero end-expiratory pressure (ZEEP), but nonlinear at PEEP. Its hysteresis was nonsignificant. In ALI/ARDS, PEEP increased lung volume by distension and recruitment, but only by distension in COPD. In ALI/ARDS, resistance was increased, at ZEEP. In COPD, resistance became extremely high during expiration at ZEEP. In ALI/ARDS at ZEEP, non-Newtonian behaviour, representing tissue stress relaxation and pendel-luft, complied with the classical linear model. At PEEP, the non-Newtonian compliance became volume-dependent to an extent correlated to the nonlinearity of the static P-V curve. In COPD, non-Newtonian behaviour was adequately explained only with a model with different inspiratory and expiratory behaviour. The classical model of the respiratory system is valid in ALI/ARDS at ZEEP. More advanced models are needed at PEEP and in COPD.

AB - Respiratory mechanics, using flow interruption, was previously studied during the complete breath in healthy ventilated man, numerical techniques relieving constraints regarding flow pattern. The classical linear model of non-Newtonian behaviour was found to be valid. The present study was extended to subjects with critical lung disease. Subjects with acute lung injury (ALI; n = 2), acute respiratory distress syndrome (ARDS; n = 4), and chronic obstructive pulmonary disease (COPD; n = 3) were studied with and without positive end-expiratory pressure (PEEP). Functional residual capacity (FRC) was measured with sulphur hexafluoride (SF6) wash-out. The static pressure-volume (P-V) curve was linear at zero end-expiratory pressure (ZEEP), but nonlinear at PEEP. Its hysteresis was nonsignificant. In ALI/ARDS, PEEP increased lung volume by distension and recruitment, but only by distension in COPD. In ALI/ARDS, resistance was increased, at ZEEP. In COPD, resistance became extremely high during expiration at ZEEP. In ALI/ARDS at ZEEP, non-Newtonian behaviour, representing tissue stress relaxation and pendel-luft, complied with the classical linear model. At PEEP, the non-Newtonian compliance became volume-dependent to an extent correlated to the nonlinearity of the static P-V curve. In COPD, non-Newtonian behaviour was adequately explained only with a model with different inspiratory and expiratory behaviour. The classical model of the respiratory system is valid in ALI/ARDS at ZEEP. More advanced models are needed at PEEP and in COPD.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Functional Residual Capacity

KW - Humans

KW - Infant, Newborn

KW - Lung

KW - Lung Diseases, Obstructive

KW - Male

KW - Middle Aged

KW - Positive-Pressure Respiration

KW - Respiration, Artificial

KW - Respiratory Distress Syndrome, Adult

KW - Respiratory Distress Syndrome, Newborn

KW - Respiratory Mechanics

KW - Respiratory Physiological Phenomena

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

M3 - Article

VL - 9

SP - 262

EP - 273

JO - European Respiratory Journal

JF - European Respiratory Journal

SN - 1399-3003

IS - 2

ER -