Assessment of respiratory system compliance under pressure control ventilation without an inspiratory pause maneuver

© 2021 Institute of Physics and Engineering in Medicine..

Objective. The measurement of the static compliance of the respiratory system (Cstat) during mechanical ventilation requires zero end-inspiratory flow. An inspiratory pause maneuver is needed if the zero end-inspiratory flow condition cannot be satisfied under normal ventilation.Approach. We propose a method to measure the quasi-static respiratory compliance (Cqstat) under pressure control ventilation mode without the inspiratory pause maneuver. First, a screening strategy was applied to filter out breaths affected strongly by spontaneous breathing efforts or artifacts. Then, we performed a virtual extrapolation of the flow-time waveform when the end-inspiratory flow was not zero, to allow for the calculation ofCqstatfor each kept cycle. Finally, the outputCqstatwas obtained as the average of the smallest 40Cqstatmeasurements. The proposed method was validated against the gold standardCstatmeasured from real clinical settings and compared with two reported algorithms. The gold standardCstatwas obtained by applying an end-inspiratory pause maneuver in the volume-control ventilation mode.Main results. Sixty-nine measurements from 36 patients were analyzed. The Bland-Altman analysis showed that the bias of agreement forCqstatversus the gold standard measurement was -0.267 ml/cmH2O (95% limits of agreement was -4.279 to 4.844 ml/cmH2O). The linear regression analysis indicated a strong correlation (R2 = 0.90) between theCqstatand gold standard.Significance. The results showed that theCqstatcan be accurately estimated from continuous ventilator waveforms, including spontaneous breathing without an inspiratory pause maneuver. This method promises to provide continuous measurements compliant with mechanical ventilation.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:42

Enthalten in:

Physiological measurement - 42(2021), 8 vom: 27. Aug.

Sprache:

Englisch

Beteiligte Personen:

Pan, Qing [VerfasserIn]
Pan, Jie [VerfasserIn]
Zhang, Zhongheng [VerfasserIn]
Fang, Luping [VerfasserIn]
Ge, Huiqing [VerfasserIn]

Links:

Volltext

Themen:

Compliance of respiratory system
Journal Article
Mechanical ventilation
Pressure control ventilation
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 20.10.2021

Date Revised 20.10.2021

published: Electronic

Citation Status MEDLINE

doi:

10.1088/1361-6579/ac1d3b

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM329278932