Inspiratory respiratory mechanics estimation by using expiratory data for reverse-triggered breathing cycles

Expiration; Intensive care; Mechanical ventilation; Model-based methods; Time constant; Biological organs; Respiratory mechanics; Ventilation; Model-based method; Time constants; Patient treatment

Abstract :

[en] Background and objective: Model-based lung mechanics monitoring can provide clinically useful information for guiding mechanical ventilator treatment in intensive care. However, many methods of measuring lung mechanics are not appropriate for both fully and partially sedated patients, and are unable provide lung mechanics metrics in real-time. This study proposes a novel method of using lung mechanics identified during passive expiration to estimate inspiratory lung mechanics for spontaneously breathing patients. Methods: Relationships between inspiratory and expiratory modeled lung mechanics were identified from clinical data from 4 fully sedated patients. The validity of these relationships were assessed using data from a further 4 spontaneously breathing patients. Results: For the fully sedated patients, a linear relationship was identified between inspiratory and expiratory elastance, with slope 1.04 and intercept 1.66. The r value of this correlation was 0.94. No cohort-wide relationship was determined for airway resistance. Expiratory elastance measurements in spontaneously breathing patients were able to produce reasonable estimates of inspiratory elastance after adjusting for the identified difference between them. Conclusions: This study shows that when conventional methods fail, typically ignored expiratory data may be able to provide clinicians with the information needed about patient condition to guide MV therapy. © 2019 Elsevier B.V.

Disciplines :

Anesthesia & intensive care

Author, co-author :

Howe, S. L.; University of Canterbury, Christchurch, 8041, New Zealand

Chase, J. G.; University of Canterbury, Christchurch, 8041, New Zealand

Redmond, D. P.; University of Canterbury, Christchurch, 8041, New Zealand

Morton, S. E.; University of Canterbury, Christchurch, 8041, New Zealand

Kim, K. T.; University of Canterbury, Christchurch, 8041, New Zealand

Pretty, C.; University of Canterbury, Christchurch, 8041, New Zealand

Shaw, G. M.; Christchurch Hospital, Christchurch, 8011, New Zealand

Tawhai, M. H.; University of Auckland, Auckland, New Zealand

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

Language :

English

Title :

Inspiratory respiratory mechanics estimation by using expiratory data for reverse-triggered breathing cycles

Publication date :

2020

Journal title :

Computer Methods and Programs in Biomedicine

ISSN :

0169-2607

eISSN :

1872-7565

Publisher :

Elsevier Ireland Ltd

Volume :

186

Peer reviewed :

Peer Reviewed verified by ORBi

Funders :

Center for Outcomes Research and Evaluation, Yale School of Medicine, CORE: E6391Tertiary Education Commission, TEC: TEC

Available on ORBi :

since 08 June 2020

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