Reliable tidal volume estimates at the airway opening with an infant monitor during high-frequency oscillatory ventilation.

Détails

ID Serval
serval:BIB_84FDB7E84AD5
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Reliable tidal volume estimates at the airway opening with an infant monitor during high-frequency oscillatory ventilation.
Périodique
Critical Care Medicine
Auteur(s)
Scalfaro P., Pillow J.J., Sly P.D., Cotting J.
ISSN
0090-3493
Statut éditorial
Publié
Date de publication
2001
Peer-reviewed
Oui
Volume
29
Numéro
10
Pages
1925-1930
Langue
anglais
Résumé
OBJECTIVE: To assess the suitability of a hot-wire anemometer infant monitoring system (Florian, Acutronic Medical Systems AG, Hirzel, Switzerland) for measuring flow and tidal volume (Vt) proximal to the endotracheal tube during high-frequency oscillatory ventilation. DESIGN: In vitro model study. SETTING: Respiratory research laboratory. SUBJECT: In vitro lung model simulating moderate to severe respiratory distress. INTERVENTION: The lung model was ventilated with a SensorMedics 3100A ventilator. Vt was recorded from the monitor display (Vt-disp) and compared with the gold standard (Vt-adiab), which was calculated using the adiabatic gas equation from pressure changes inside the model. MEASUREMENTS AND MAIN RESULTS: A range of Vt (1-10 mL), frequencies (5-15 Hz), pressure amplitudes (10-90 cm H2O), inspiratory times (30% to 50%), and Fio2 (0.21-1.0) was used. Accuracy was determined by using modified Bland-Altman plots (95% limits of agreement). An exponential decrease in Vt was observed with increasing oscillatory frequency. Mean DeltaVt-disp was 0.6 mL (limits of agreement, -1.0 to 2.1) with a linear frequency dependence. Mean DeltaVt-disp was -0.2 mL (limits of agreement, -0.5 to 0.1) with increasing pressure amplitude and -0.2 mL (limits of agreement, -0.3 to -0.1) with increasing inspiratory time. Humidity and heating did not affect error, whereas increasing Fio2 from 0.21 to 1.0 increased mean error by 6.3% (+/-2.5%). CONCLUSIONS: The Florian infant hot-wire flowmeter and monitoring system provides reliable measurements of Vt at the airway opening during high-frequency oscillatory ventilation when employed at frequencies of 8-13 Hz. The bedside application could improve monitoring of patients receiving high-frequency oscillatory ventilation, favor a better understanding of the physiologic consequences of different high-frequency oscillatory ventilation strategies, and therefore optimize treatment.
Mots-clé
Airway Resistance/physiology, Equipment Design, Equipment Safety, High-Frequency Ventilation/instrumentation, High-Frequency Ventilation/methods, Humans, Infant, Newborn, Models, Biological, Predictive Value of Tests, Sensitivity and Specificity, Tidal Volume, Ventilators, Mechanical
Pubmed
Web of science
Création de la notice
24/01/2008 17:41
Dernière modification de la notice
03/03/2018 18:56
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