Negative Lung Elastance in Mechanically Ventilated Spontaneously Breathing Patient

Biological organs; Intensive care units; Respiratory mechanics; Respiratory system; Area Under the Curve (AUC); Clinical data; Clinical protocols; Continuous data; Inter quartile ranges; Negative pressures; Sedated patients; Spontaneous breathing; Decision making

Abstract :

[en] Mathematical modelling of respiratory system can guide clinicians in better monitoring and decision making for mechanically ventilated (MV) patients in intensive care unit (ICU). However, most mathematical models are develop for fully sedated patients and not particularly reliable to be applied for spontaneous breathing (SB) patients. Monitoring respiratory mechanics of SB patients requires invasive clinical protocols and equipment that are clinically too intensive to carry out. Previous study hypothesized that negative elastance occurred in SB patients due to the SB effort produced by the patient. Thus, this paper aims to further investigate the distribution of negative elastance in SB patients by extending the noninvasive time-varying elastance model. By capturing and reviewing the distribution of the negative elastance in SB patient, it can provide more consistent monitoring and decision making particularly for SB patients. Clinical data from 5 MV patients from Christchurch Hospital were used in this study. The area under the curve (AUC) for the time-varying elastance, Edrs, is estimated and analysed in each SB patient. The results are reported as median and interquartile range (IQR) for continuous data with a total of 82 hours. From the result, it was found that all patients have distribution of negative elastance with Patients 1 and 3 have higher distribution of negative elastance due to the SB effort. The median vaue for the negative elastance for all patients’ ranges from -0.66 cmH20.s/l to -2.27 cmH20.s/l. Negative elastance occurs when negative pressure is generated in the patient's pleural space causing air volume to enter the lung. Thus, by capturing and reviewing the distribution of the negative elastance in SB patient, it can provide more consistent monitoring and decision making particularly for SB patients. © 2017

Disciplines :

Anesthesia & intensive care

Author, co-author :

Damanhuri, N. S.; Faculty of Electrical Engineering, Universiti Teknologi MARA (UiTM)Pulau Pinang, Malaysia

Chiew, Y. S.; Department of Intensive Care, Christchurch Hospital, Christchurch, New Zealand

Docherty, P. D.; Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand

Othman, N. A.; Faculty of Electrical Engineering, Universiti Teknologi MARA (UiTM)Pulau Pinang, Malaysia

Shaw, G. M.; Department of Intensive Care, Christchurch Hospital, Christchurch, New Zealand

Desaive, Thomas ; Université de Liège - ULiège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles

Chase, J. G.; Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand

Language :

English

Title :

Negative Lung Elastance in Mechanically Ventilated Spontaneously Breathing Patient

Publication date :

2017

Event name :

20th IFAC world congress

Event date :

11-17 juillet 2017

By request :

Yes

Audience :

International

Journal title :

IFAC-PapersOnLine

ISSN :

2405-8971

eISSN :

2405-8963

Publisher :

Elsevier B.V.

Volume :

Issue :

Pages :

15179-15184

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 08 June 2020

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