Document Detail

Detection of expiratory flow limitation during mechanical ventilation.
MedLine Citation:
PMID:  7952558     Owner:  NLM     Status:  MEDLINE    
Two new methods, application of negative pressure at the airway opening during expiration (NEP) and reduction of flow resistance by bypassing the expiratory line of the ventilator by exhaling into the atmosphere (ATM), were used to detect expiratory flow limitation in 12 semirecumbent (45 degree) mechanically ventilated patients, seven with chronic airway obstruction (CAO). An increase of expiratory flow with NEP or ATM, relative to the preceding control breath, was taken as indicating absence of expiratory flow limitation. By contrast, the portion of the tidal expiration over which there was no change in flow with NEP or ATM was considered as flow-limited. With NEP, nine patients exhibited flow limitation, six (all with CAO) were flow-limited over most of the tidal expiration (> 70% VT), and three at < 60% VT. Although the results with NEP and ATM were in general in good agreement, in the three non-flow-limited patients the ATM method gave erroneous results. Six patients were also studied supine, including two who were not flow-limited when semirecumbent: both became flow-limited when supine. We conclude that NEP provides a simple method to detect flow limitation in mechanically ventilated patients. The supine position enhances flow limitation.
P Valta; C Corbeil; A Lavoie; R Campodonico; N Koulouris; M Chassé; J Braidy; J Milic-Emili
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  150     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1994-12-13     Completed Date:  1994-12-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1311-7     Citation Subset:  AIM; IM    
Respiratory Division, Hôpital Saint-Luc, Université de Montréal, Quebec, Canada.
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MeSH Terms
Aged, 80 and over
Lung Diseases, Obstructive / complications
Middle Aged
Pulmonary Ventilation*
Respiration, Artificial*
Respiratory Insufficiency / etiology,  physiopathology,  therapy
Supine Position

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