| End-inspiratory airway occlusion: a method to assess the pressure developed by inspiratory muscles in patients with acute lung injury undergoing pressure support. | |
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MedLine Citation:
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PMID: 9351624 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We evaluated the end-inspiratory occlusion maneuver as a means to estimate the inspiratory effort during pressure support ventilation (PS). In nine nonobstructed acute lung injury (ALI) patients, we applied four levels of PS (0, 5, 10, 15 cm H2O) to modify the inspiratory effort. End inspiratory occlusions (2 to 3 s) were performed at the end of each experimental period by pushing the inspiratory hold button of the ventilator (Servo 900 C; Siemens, Berlin, Germany). We took the difference between the end-inspiratory occlusion plateau pressure and the airway pressure before the occlusion (PEEP + PS) as an estimate of the inspiratory effort and called it PMI (Pmusc,index). From the esophageal pressure tracing we obtained a reference measurement of the pressure developed by the inspiratory muscles at end inspiration (Pmusc,ei) and of the pressure-time product per breath (PTP/b) and per minute (PTP/min). In each patient, PMI was correlated with Pmusc,ei (p < 0.01) and PTP/b (p < 0.01). A PMI threshold of 6 cm H2O detected PTP/min < 125 cm H2O s/min with a sensitivity of 0.89 and a specificity of 0.89. We conclude that PMI is a good estimate of the pressure developed by the inspiratory muscles in ALI patients and may be used to titrate PS level. The major advantage of PMI is that it can be obtained from the ventilator display without any additional equipment. |
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Authors:
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G Foti; M Cereda; G Banfi; P Pelosi; R Fumagalli; A Pesenti |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: American journal of respiratory and critical care medicine Volume: 156 ISSN: 1073-449X ISO Abbreviation: Am. J. Respir. Crit. Care Med. Publication Date: 1997 Oct |
Date Detail:
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Created Date: 1997-11-18 Completed Date: 1997-11-18 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1210-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesia and Intensive Care, Ospedale S. Gerardo, Monza, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adolescent Adult Aged Airway Resistance / physiology* Female Humans Intermittent Positive-Pressure Ventilation / methods* Male Middle Aged Predictive Value of Tests Reproducibility of Results Respiratory Distress Syndrome, Adult / physiopathology*, therapy Respiratory Mechanics / physiology* Respiratory Muscles / physiology* Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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