Effect of Continuous Positive Airway Pressure on the Measurement of Thoracoabdominal Asynchrony and Minute Ventilation in Children Anesthetized With Sevoflurane and Nitrous Oxide

Reber, A.; Geiduschek, Jeremy M.; Bobbià, S.A.; Bruppacher, Heinz R.; Frei, Franz J.

doi:10.1378/chest.122.2.473

Cited by 30 publications

(17 citation statements)

References 22 publications

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“…Several studies [6][7][8][9][10] have proved the effi ciency of non-invasive ventilation (NIV) in the weaning procedure and maintenance of spontaneous ventilation. The authors report that the utilization of this type of procedure promotes a decrease in ventilation work and in dyspnea, and an increase in residual volume, thus preventing the presence of atelectasis and favoring alveolar recruitment as well as increasing partial pressure of oxygen in the arterial blood (paO 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Estudo comparativo entre a pressão positiva intermitente (Reanimador de Müller) e contínua no pós-operatório de cirurgia de revascularização do miocárdio

Müller¹,

Olandoski²,

Macedo³

et al. 2006

Arq. Bras. Cardiol.

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OBJECTIVETo compare the effect of the use of intermittent and continuous positive airway pressure in postoperative patients undergoing coronary artery bypass grafting. METHODSThis study included forty patients divided into two groups: one undergoing continuous positive airway pressure (CPAP Group), and the other undergoing intermittent pressure (Müller Resuscitator Group). The patients were evaluated in relation to the several study variables at the following time points: preoperative, 3rd, 24th, and 48th hours. RESULTSThe patient groups were homogeneous in relation to the several demographic and clinical variables. The values of pO 2 , pCO 2 and sO 2 were within normal limits and no signifi cant differences were found between the groups. Regarding respirometry, the groups showed signifi cant differences in the tidal volume and respiratory rate at the 48th postoperative hour. Dyspnea and use of accessory muscle in postoperative assessments were found with a signifi cantly higher frequency in patients undergoing CPAP. Patients undergoing Müller Resuscitator had a normal chest radiograph more frequently than did patients undergoing CPAP. CONCLUSIONBoth devices were shown to be able to keep pO 2 , pCO 2 , and sO 2 values within normal limits. However, when the objective was pulmonary reexpansion with less imposed workload, the Müller Resuscitator was more effective because of its prompter action and consequently lower levels of dyspnea, respiratory rate (RR) and use of accessory muscle were observed. KEY WORDSIPPB, continuous positive airway pressure, physical therapy.

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Section: Resultsmentioning

confidence: 99%

“…The treatment with CPAP provides an improvement in RV, with a subsequent maintenance of TV 6,7,8,9,16 . However, the use of IPPB is recommended to increase TV directly 23,11 .…”

Section: Discussionmentioning

confidence: 99%

Estudo comparativo entre a pressão positiva intermitente (Reanimador de Müller) e contínua no pós-operatório de cirurgia de revascularização do miocárdio

Müller¹,

Olandoski²,

Macedo³

et al. 2006

Arq. Bras. Cardiol.

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“…However, PEP-induced changes on lung volumes are not fully established due to muscular limitations and consequent respiratory muscles asynchronous activity that may be present in children with CF 11 . Besides lung disorders, children with CF frequently show paradoxical or asynchronous motion between chest wall and abdomen during breathing [12][13][14] . This alteration is related to disease severity, increased risk of respiratory failure, and poor prognosis in patients with obstructive disease 15,16 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of different levels of positive expiratory pressure on chest wall volumes in healthy children and patients with fibrosis

et al. 2017

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Positive Expiratory Pressure (PEP) improves lung function, however, PEP-induced changes are not fully established. The aim of this study was to assess the acute effects of different PEP levels on chest wall volumes and the breathing pattern in children with Cystic Fibrosis (CF). Anthropometric data, lung function values, and respiratory muscle strength were collected. Chest wall volumes were assessed by Optoelectronic plethysmography at rest and during the use of different PEP levels (10 and 20 cm H2O), randomly chosen. Eight subjects with CF (5M, 11.5±3.2 years, 32±9.5 kilograms) and seven control subjects (4M, 10.7±1.5 years, 38.2±7.8 kilograms) were recruited. The CF group showed significantly lower FEF values 25-75% (CF: 1.8±0.8 vs. CG: 2.3±0.6) and FEV1/FVC ratio (CF: 0.8±0.1 vs. CG: 1±0.1) compared with the control group (p<0.05). Different PEP levels increased the usual volume in chest wall and its compartments in both groups; however, this volume was significantly higher in the control group compared with the CF group during PEP20 (CW: 0.77±0.25 L vs. 0.44±0.16 L; RCp: 0.3±0.13 L vs. 0.18±0.1 L; RCa: 0.21±0.1 L vs. 0.12±0.1 L; AB: 0.25±0.1 L vs. 0.15±0.1 L; p<0.05 for all variables). Minute ventilation was significantly higher during PEP compared with breathing at rest in both groups (p<0.005). End-expiratory volume was also higher during PEP compared with breathing at rest for chest wall and pulmonary rib cage in both groups (p<0.05). Different PEP levels may increase chest wall volumes in CF patients.

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“…The following variables were measured by a digital acquisition system on a breath-by-breath basis (RespiEvents ® , Nims, Miami, FL, USA): tidal volume (V T ), respiratory frequency (f), minute ventilation (V E ), inspiratory time (Ti), inspiratory duty cycle (Ti/Ttot), mean inspiratory flow (V T /Ti), RC motion contribution to V T (RC/V T ), phase angle (PhAng; 0° for complete RC-AB synchrony and 180° for complete asynchrony) 20 , inspiratory RC-AB synchrony (PhRIB), expiratory RC-AB synchrony (PhREB), inspiratory and expiratory synchrony (PhRTB), variables that represent the time percentage during a respiratory cycle in which the RC and AB move in opposite directions. When the RC and AB are moving in perfect synchrony, the values are equivalent to 0%, and when there is paradoxical movement, they are equivalent to 100% 20 .…”

Section: Methodsmentioning

confidence: 99%

“…When the RC and AB are moving in perfect synchrony, the values are equivalent to 0%, and when there is paradoxical movement, they are equivalent to 100% 20 . The contribution of abdominal motion to V T (AB/V T ) was calculated as AB/V T = 100 -RC/V T .…”

Section: Methodsmentioning

confidence: 99%

Ventilatory and muscular assessment in healthy subjects during an activity of daily living with unsupported arm elevation

Panka

Oliveira²,

França

et al. 2010

Rev. bras. fisioter.

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Effect of Continuous Positive Airway Pressure on the Measurement of Thoracoabdominal Asynchrony and Minute Ventilation in Children Anesthetized With Sevoflurane and Nitrous Oxide

Cited by 30 publications

References 22 publications

Estudo comparativo entre a pressão positiva intermitente (Reanimador de Müller) e contínua no pós-operatório de cirurgia de revascularização do miocárdio

Estudo comparativo entre a pressão positiva intermitente (Reanimador de Müller) e contínua no pós-operatório de cirurgia de revascularização do miocárdio

Comparison of different levels of positive expiratory pressure on chest wall volumes in healthy children and patients with fibrosis

Ventilatory and muscular assessment in healthy subjects during an activity of daily living with unsupported arm elevation

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