Document Detail

Dynamic measurement of intrinsic PEEP does not represent the lowest intrinsic PEEP.
MedLine Citation:
PMID:  10229161     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Dynamic intrinsic PEEP (PEEPi-dyn) is the airway pressure required to overcome expiratory flow and is considered to represent the lowest regional PEEPi. However, there are few data to validate this assumption. We investigated if PEEPi-dyn represents the lowest PEEPi. SETTING: The animal laboratory at the Osaka University Medical School. MEASUREMENTS AND RESULTS: We compared static PEEPi (PEEPi-stat) and PEEPi-dyn in healthy animals. Five adult white rabbits (2.77+/-0.05 kg) were anesthetized, tracheostomized, and intubated with several different sizes of endotracheal tubes (ETT) (2.0, 2.5, 3.0, 3.5, or 4.0 mm i.d.). The animals were paralyzed and ventilated (Siemens Servo 900C). Baseline ventilator settings were at a rate of 50/min, inspiratory:expiratory (I:E) ratio of 2:1 or 4:1, and minute ventilation was manipulated to create 3 or 5 cm H2O PEEPi-stat. PEEPi-stat was measured using the expiratory hold button of the ventilator. PEEPi-dyn showed large variations. In all ventilator settings, PEEPi-dyn was higher than PEEPi-stat (p<0.001). The larger the ETT, the higher the PEEPi-dyn at an I:E ratio of 2:1 (p<0.05). The higher the minute ventilation, the greater the difference between PEEPi-stat and PEEPi-dyn. The tidal volume and the difference showed a significant correlation (r2 = 0.514, p<0.001). CONCLUSIONS: The value of PEEPi-dyn was dependent on ventilatory settings, and PEEPi-dyn does not necessarily represent the lowest regional PEEPi within the lungs.
Y Fujino; M Nishimura; A Uchiyama; N Taenaka; I Yoshiya
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  25     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-07-08     Completed Date:  1999-07-08     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  274-8     Citation Subset:  IM    
Intensive Care Unit, Osaka University Hospital, Suita, Japan.
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MeSH Terms
Positive-Pressure Respiration, Intrinsic / metabolism*
Respiration, Artificial*
Comment In:
Intensive Care Med. 1999 Jul;25(7):768-9   [PMID:  10470589 ]
Intensive Care Med. 1999 Mar;25(3):252-4   [PMID:  10229157 ]

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