Analysis of Dynamic Intratidal Compliance in a Lung Collapse Model

Schumann, Stefan; Vimláti, L; Kawati, Rafael; Guttmann, J.; Lichtwarck-Aschoff, Michael

doi:10.1097/aln.0b013e31820ad41b

Cited by 28 publications

(24 citation statements)

References 21 publications

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“…Our observations confirm that PEEP significantly contributes to improved compliance of the pulmonary parenchyma [17]. According to recent studies, the use of a PEEP at even 5 cm H 2 O increases compliance by 20%; the PEEP recommended by Wallet and co-workers in patients with ARDS is 15 cm H 2 O [18].…”

Section: Discussionsupporting

confidence: 75%

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Wpływ jednostronnego PEEP na biomechanikę obu płuc podczas niezależnej wentylacji u chorych znieczulanych do zabiegów torakochirurgicznych

Trela-Stachurska¹,

Nestorowicz²,

Kotlińska-Hasiec³

et al. 2015

Anaesthesiol Intensive Ther

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Background: Synchronous independent lung ventilation (ILV) is the treatment of choice for unilateral pathology of lung parenchyma. Numerous studies have documented the improved blood oxygenation and clinical efficacy of this procedure. The aim of the present study was to evaluate the effects of ILV on the selected biomechanical parameters of the lungs. Method: The study involved ASA I-II patients undergoing thoracic surgery in the lateral decubitus position under the standard conditions of general anaesthesia with the thoracic cavity closed. ILV with equal separation of the tidal volume was performed with a prototype volume separator, using incremental a PEEP of 0−15 cm H 2 O in the dependent lung. Peak pressures, dynamic compliance and airway resistance of both lungs were evaluated. Results: The study included 36 patients. In all of the patients, a PEEP of 5−15 cm H 2 O in one lung increased its peak pressures, dynamic compliance and resistances, and variably affected the biomechanical parameters of the other lung. Irrespective of patient positioning on the right or left side, the highest compliance was recorded at a PEEP of 10 cm H 2 O. Conclusions: In ILV, peak pressures and airway resistances are higher in the dependent lung compared to compliances in the non-dependent lung. ILV with a PEEP of 5−15 cm H 2 O increases the biomechanical parameters of the dependent lung while variably influencing the parameters in the non-dependent lung.

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Section: Discussionsupporting

confidence: 75%

“…The highest compliance was noted at a PEEP of 10 cm H 2 O, which is comparable to the data presented by Schumann and colleagues [17]. In our study, dynamic compliance of the lung deteriorated at 15 cm H 2 O PEEP, which contradicts the findings published by Kingstedt and co-workers, who used a PEEP of 16 cm H 2 O [12].…”

Section: Discussioncontrasting

confidence: 57%

Wpływ jednostronnego PEEP na biomechanikę obu płuc podczas niezależnej wentylacji u chorych znieczulanych do zabiegów torakochirurgicznych

Trela-Stachurska¹,

Nestorowicz²,

Kotlińska-Hasiec³

et al. 2015

Anaesthesiol Intensive Ther

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“…Differences in global lung mechanics during static or quasi-static and dynamic ventilatory conditions have long been known (27). It has recently been shown that lung mechanics assessed during continuous ventilationarehelpfulinadjustingindividual ventilatory settings (2,4,(42)(43)(44)(45). As assessment of dynamic lung mechanics does not require invasive interventions and allows continuous assessment of ventilatory settings, they may be of clinical interest.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Imaging to Assess Alveolar Mechanics During Quasi-static and Dynamic Ventilatory Conditions in Rats With Noninjured and Injured Lungs*

Schwenninger

Runck²,

Schumann³

et al. 2013

Critical Care Medicine

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“…MAP IBP and MAP CNP were compared using the ISO81060-2 standard [1] for non-invasive intermittent blood pressure devices and the Bland-Altman approach. Correlation analysis of changes of device relating differences ∆eMAP=∆MAP CNP -∆MAP IBP with changes of MAP IBP (∆MAP IBP ) during intervals of drug induced vasoactivity was conducted.…”

Section: Methodsmentioning

confidence: 99%

“…To avoid ventilator induced lung injury, positive end-expiratory pressure (PEEP) should be titrated to a value resulting in a horizontal volume-dependent intratidal compliance-profile at a high level [1]. In this compliance-range the PEEP is high enough to stabilize collapsible alveolar areas mechanically and thus to prevent the intratidal recruitment/derecruitment of alveoli.…”

Section: Introductionmentioning

confidence: 99%

Track F. New developments in monitoring

Fiedler¹,

Stark²,

Mueller³

2015

Biomedical Engineering / Biomedizinische Technik

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IntroductionThe scattering and absorption of light in blood is mostly caused by the red blood cells. Light scattering strongly affects the spectral analysis of blood components. The currently most used standard method to determine the concentration of substances like lactate or glucose in blood samples is the enzymatic-amperometric measuring principle. The goal of our research is the development of an optical measuring setup to determine the concentration of substances with spectral analysis in whole blood samples. To achieve reliable results it is necessary to create a clear optical path. Therefore we compared different methods to determine their performance. MethodsResearch has shown that there are various approaches to separate plasma from the cellular blood components. Most papers describe microfluidic based technologies. In general there are three approaches to successfully fractionate the blood components without centrifugation. One approache is the use of high gradient magnetic fields (HGMS) where the magnetic properties of the blood cells are used. Ultrasound is another way to fractionate the blood components. The ultrasound is used to generate an orthogonal standing wavefield to the flowdirection of the blood cells to focus the cells in the centre of the flow channel. A third approach is dielectrophoresis (DEP) where a strong DEP force traps the blood cells at the elctrodes. The different approaches where theoretical evaluated with regard to there possible results and implementation to reduce light scattering. ResultsThe theoretical evaluation showed that HGMS will provide the best results in regard to reduce the light scattering. It will also be the least complex aproach for the implementation. A demonstration setup was developed which allows it to separate plasma from the cellular blood components. ConclusionHGMS is a possible solution to reduce light scattering in blood samples in order to perfom spectral measurments. The demonstration setup is under further development to create an optical path in an implementable time domain. IntroductionLactate is an important indicator of human metabolism performance. In addition to determine the anerobic threshold for athletes lactate plays a steadily increasing role in clinical medicine. Thus, a fast, reliable and affordable determination is proposed. Up to now measurement of lactate is conducted mostly by enzymatic reactions. One big disadvantage of these reactions is that the used enzymes are not longterm stable. The goal of our research is to develop a method for optical in vitro lactate measurements in practice. Since commercial implementation of FTIR-spectrometers brings some issues, lactate concentration should be determined by using discrete wavelengths. MethodsResearch has shown that optical NIR in vitro determination of lactate is possible, but only with substantial technical and financial effort. We are planning to develop a less complex optical and affordable method to measure lactate concentration. For this purpose we analysed selected blood componen...

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Analysis of Dynamic Intratidal Compliance in a Lung Collapse Model

Cited by 28 publications

References 21 publications

Wpływ jednostronnego PEEP na biomechanikę obu płuc podczas niezależnej wentylacji u chorych znieczulanych do zabiegów torakochirurgicznych

Wpływ jednostronnego PEEP na biomechanikę obu płuc podczas niezależnej wentylacji u chorych znieczulanych do zabiegów torakochirurgicznych

Endoscopic Imaging to Assess Alveolar Mechanics During Quasi-static and Dynamic Ventilatory Conditions in Rats With Noninjured and Injured Lungs*

Track F. New developments in monitoring

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