Document Detail


Lung and chest wall mechanics in normal anaesthetized subjects and in patients with COPD at different PEEP levels.
MedLine Citation:
PMID:  9426093     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In order to assess the relative contribution of the lung and the chest wall to the derangements of respiratory mechanics in chronic obstructive pulmonary disease (COPD) patients with acute ventilatory failure (AVF), we studied eight COPD patients undergoing controlled mechanical ventilation for AVF and nine normal subjects anaesthetized for surgery as a control group. With the use of the interrupter technique together with the oesophageal balloon technique we measured: static lung and chest wall elastances (E[st,L] and E[st,w], respectively), maximum (R[L,max]), minimum (R[L,min]) and additional (deltaR[L]) lung resistances, additional chest wall resistance (deltaRw) and, in the COPD group, total intrinsic positive end-expiratory pressure (PEEPtot). Measurements were repeated at 0, 5, 10 and 15 cmH2O of applied positive end-expiratory pressure (PEEP). We found that, in the COPD group: 1) both E(st,w) and deltaRw were higher than in the normal group; 2) R(L,max) was markedly increased due to an increase of both R(L,min) and deltaRL; 3) even low levels of PEEP increased PEEPtot; 4) PEEP did not reduce elastance or total resistance of either the lung or the chest wall. We conclude that chest wall mechanics are abnormal in chronic obstructive pulmonary disease patients with acute ventilatory failure undergoing controlled mechanical ventilation and that positive end-expiratory pressure does not seem to be effective in reducing either elastance or resistance of the lung or chest wall.
Authors:
G Musch; G Foti; M Cereda; P Pelosi; D Poppi; A Pesenti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The European respiratory journal     Volume:  10     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1998-02-05     Completed Date:  1998-02-05     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  2545-52     Citation Subset:  IM    
Affiliation:
Istituto di Anestesiologia e Rianimazione, Università degli Studi di Milano, Italy.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, General
Case-Control Studies
Female
Humans
Lung / physiopathology
Lung Diseases, Obstructive / complications,  physiopathology*,  therapy*
Male
Middle Aged
Positive-Pressure Respiration*
Pulmonary Ventilation / physiology
Respiratory Insufficiency / etiology,  physiopathology*,  therapy*
Respiratory Mechanics / physiology*

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