Document Detail

Effect of continuous positive airway pressure (CPAP) in patients with chronic obstructive pulmonary disease (COPD) depending on intrinsic PEEP levels.
MedLine Citation:
PMID:  8607317     Owner:  NLM     Status:  MEDLINE    
The application of continuous positive airway pressure (CPAP) is known to reduce inspiratory work of breathing in intubated patients with chronic obstructive pulmonary disease (COPD). This effect is caused by a decrease in elastic work related to a reduction in intrinsic PEEP. The aim of this study was to relate the decrease in inspiratory work due to CPAP to the intrinsic PEEP levels obtained during spontaneous breathing without positive pressure. Ten intubated patients with COPD who had been ventilated for acute respiratory failure were studied. Intrinsic PEEP was determined during tracheal occlusions performed at end-expiration when the patient was breathing without positive airway pressure. Inspiratory work was computed during breathing through a circuit with a CPAP of 0.5 kPa and the same circuit without positive pressure. Intrinsic PEEP-levels ranged from 0.26 to 1.31 kPa. Compared to spontaneous breathing without positive pressure, CPAP reduced the total inspiratory work per liter of ventilation (Wltot) from 1.42 +/- 0.48 to 1.24 +/- 0.50 J.1-1 (means +/- SD P < 0.01). This decrease was found to be related to the intrinsic PEEP-levels; the largest reductions were found in the patients with an intrinsic PEEP-level close to the CPAP-level applied. In intubated patients with COPD, the decrease in Wltot due to a CPAP of 0.5 kPa was found to be related to the intrinsic PEEP-levels present when no positive airway pressure was applied. The intrinsic PEEP measured during tracheal occlusions could be used to estimate the effect of CPAP in these patients.
B van den Berg; J G Aerts; J M Bogaard
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  39     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  1995 Nov 
Date Detail:
Created Date:  1996-05-23     Completed Date:  1996-05-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  1097-102     Citation Subset:  IM    
Respiratory Intensive Care Unit, University Hospital, Erasmus University, Rotterdam, The Netherlands.
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MeSH Terms
Aged, 80 and over
Lung Diseases, Obstructive / physiopathology*
Positive-Pressure Respiration*

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