| Respiratory oscillation mechanics in infants with bronchiolitis during mechanical ventilation. | |
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MedLine Citation:
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PMID: 9475327 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of the study was to describe the pattern of respiratory oscillation mechanics and responses to positive end-expiratory pressure (PEEP) in bronchiolitis. Six infants were studied during the course of mechanical ventilation. A 20 Hz sinusoidal pressure variation was applied at the endotracheal tube where flow was measured with a pneumotachograph. Resistance and reactance obtained from the complex pressure-flow ratio were separated during inspiration (R(rs,i); X(rs,i)) and expiration (R(rs,e); X(rs,e)), and the differences between R(rs,i) and R(rs,e) (deltaR(rs)) and X(rs,i) and X(rs,e) (deltaX(rs)) were calculated. The data were corrected for the mechanical characteristics of the endotracheal tube. The measurements were repeated while PEEP was varied between 0 and 8 hPa. Two infants were found to have normal R(rs) and near-zero X(rs) and both parameters exhibited little change within the respiratory cycle or with varying PEEP. Four infants had high R(rs) at zero PEEP. In two, R(rs,i) was markedly elevated (108.5 and 85.2 hPa.s/L, respectively), and X(rs,i) was markedly negative (-25.0 and -22.5 hPa.s/L, respectively) at zero PEEP, while deltaR(rs) and deltaX(rs) were small. R(rs,i) and the absolute value of X(rs,i) decreased with increasing PEEP. This pattern of oscillation mechanics was consistent with low lung volumes and atelectasis, being reversed by increasing PEEP. In the remaining two subjects, R(rs,i) was moderately elevated (57.8 and 53.6 hPa.s/L, respectively) and X(rs,i) moderately negative (-12.5 and -7.7 hPa.s/L, respectively) at zero PEEP. DeltaR(rs) (-59.8 and -56.5 hPa.s/L, respectively) and delta(rs) (28.1 and 48.7 hPa.s/L, respectively) were large, but were dramatically reduced by increasing PEEP. These patterns were consistent with expiratory airflow limitation. Measurements of respiratory impedance are, therefore, informative in regard to the pathophysiological mechanisms occurring in bronchiolitis during mechanical ventilation, and they may be helpful in setting the level and assessing the effect of PEEP. |
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Authors:
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R Gauthier; C Beyaert; F Feillet; R Peslin; P Monin; F Marchal |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pediatric pulmonology Volume: 25 ISSN: 8755-6863 ISO Abbreviation: Pediatr. Pulmonol. Publication Date: 1998 Jan |
Date Detail:
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Created Date: 1998-04-02 Completed Date: 1998-04-02 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8510590 Medline TA: Pediatr Pulmonol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 18-31 Citation Subset: IM |
Affiliation:
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Laboratoire d'Explorations Fonctionnelles Pédiatriques, Hôpital-d'Enfants Vandoeuvre les Nancy, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Airway Resistance
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physiology Bronchiolitis / physiopathology*, therapy* Female High-Frequency Ventilation* Humans Infant Infant, Newborn Intubation, Intratracheal Male Positive-Pressure Respiration Respiratory Mechanics* |
| Comments/Corrections | |
Comment In:
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Pediatr Pulmonol. 1998 Dec;26(6):438-41
[PMID:
9888220
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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