Affiliation:
1. The George Washington University
Abstract
Abstract
Purpose
This study introduces a method to non-invasively and automatically quantify respiratory muscle effort (Pmus) during mechanical ventilation (MV). The methodology hinges on numerically solving the respiratory system's equation of motion, utilizing measurements of airway pressure (Paw) and airflow (Faw). To evaluate the technique's effectiveness, Pmus was correlated with expected physiological responses. In volume-control (VC) mode, where tidal volume (VT) is pre-determined, Pmus is expected to be linked to Paw fluctuations. In contrast, during pressure-control (PC) mode, where Paw is held constant, Pmus should correlate with VT variations.
Methods
The study utilized data from 250 patients on invasive MV. The data included detailed recordings of Paw and Faw, sampled at 31.25 Hz and saved in 131.2-second epochs, each covering 34 to 41 breaths. The algorithm identified 51,268 epochs containing breaths on either VC or PC mode exclusively. In these epochs, Pmus and its pressure-time product (PmusPTP) were computed and correlated with Paw's pressure-time product (PawPTP) and VT, respectively.
Publisher
Research Square Platform LLC
Reference24 articles.
1. Slutsky AS, Ranieri VM. (2013) Ventilator-induced lung injury. N Engl J Med. 369:2126–2136,. doi: 10.1056/NEJMra1208707. Erratum in: N Engl J Med. 370:1668–1669, 2014. PMID: 24283226.
2. Static and Dynamic Contributors to Ventilator-induced Lung Injury in Clinical Practice. Pressure, Energy, and Power;Marini JJ;Am J Respir Crit Care Med,2020
3. Demoule A, Hajage D, Messika J, Jaber S, Diallo H, Coutrot M, Kouatchet A, Azoulay E, Fartoukh M, Hraiech S, Beuret P, Darmon M, Decavèle M, Ricard JD, Chanques G, Mercat A, Schmidt M, Similowski T, REVA Network (Research Network in Mechanical Ventilation). ; (2022) Prevalence, Intensity, and Clinical Impact of Dyspnea in Critically Ill Patients Receiving Invasive Ventilation. Am J Respir Crit Care Med. 205:917–926. 10.1164/rccm.202108-1857OC. PMID: 35061577.
4. Dyspnea, Acute Respiratory Failure, Psychological Trauma, and Post-ICU Mental Health: A Caution and a Call for Research;Worsham CM;Chest,2021
5. Der Zusammenhang der Atemkräfte und ihre Abhängigkeit vom Dehnungszustand der Atmungsorgane;Rohrer F;Pflüger's Arch,1916