Expiratory trigger setting in pressure support ventilation: from mathematical model to bedside.

Details

Serval ID
serval:BIB_0AE3A63F2418
Type
Article: article from journal or magazin.
Collection
Publications
Title
Expiratory trigger setting in pressure support ventilation: from mathematical model to bedside.
Journal
Critical Care Medicine
Author(s)
Tassaux D., Michotte J.B., Gainnier M., Gratadour P., Fonseca S., Jolliet P.
ISSN
0090-3493 (Print)
ISSN-L
0090-3493
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
32
Number
9
Pages
1844-1850
Language
english
Notes
Publication types: Evaluation Studies ; Journal ArticlePublication Status: ppublish
Abstract
OBJECTIVE: To evaluate the feasibility of relying on a mathematical model to adjust the optimal level of expiratory trigger, materialized by the ratio of inspiratory flow at the end of inspiratory effort (V'ti) and peak inspiratory flow (V'peak), or V'ti/V'peak, during pressure support, by comparing its predicted values with those measured in intubated patients.
DESIGN: Prospective observational study.
SETTING: Medical intensive care unit, university hospital.
PATIENTS: There were 28 intubated patients undergoing pressure support.
INTERVENTIONS: Pressure support as set by the clinician in charge.
MEASUREMENTS AND MAIN RESULTS: A significant correlation was found between predicted and measured V'ti/V'peak ratios (r =.70; p <.001; mean +/- sd difference, -0.025 +/- 0.07; 95% confidence interval, -0.161 to 0.111). Overall, delayed cycling occurred in obstructive conditions, the delay increasing as obstructive disease was more severe.
CONCLUSIONS: A significant correlation was observed between predicted values of V'ti/V'peak and those values measured in patients undergoing pressure support. These findings should stimulate further research into the possible applications of this mathematical model to optimize expiratory trigger setting. Furthermore, our findings suggest that expiratory trigger should be adjustable and provide a wider range of cutoff levels than that which is currently available.
Keywords
Feasibility Studies, Humans, Middle Aged, Models, Biological, Positive-Pressure Respiration/methods, Predictive Value of Tests, Prospective Studies, Respiratory Mechanics/physiology, Statistics, Nonparametric, Tidal Volume
Pubmed
Web of science
Create date
27/06/2013 14:36
Last modification date
20/08/2019 12:32
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