Optimal endexpiratory airway pressure for ventilated patients

Wolff, G.; Langenstein, H; Schwendener, R; Lischer, P

doi:10.1007/bf01686852

Cited by 8 publications

(1 citation statement)

References 23 publications

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“…These conclusions were subsequently challenged. It was pointed out that if differences in patient characteristics are taken into account, no measurable physiologic variable is helpful in predicting the best CPAP in a given situation (7). Analysis of expired gas has been proposed as a useful noninvasive means of titrating end-expiratory positive pressure (4).…”

Section: Discussionmentioning

confidence: 99%

Lung carbon dioxide elimination rate (LCO2) correlates with physiologic deadspace volume during mechanical ventilatory support

Sungur

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Gabrielli

et al. 1999

Critical Care Medicine

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Increased mean airway pressure (P aw ) predisposes to increased alveolar dead space volume and, hence, physiologic dead space volume (V Dphys ). This is the result of overdistending alveoli, converting Zone 2 and Zone 3 units to Zone 1 units. Lung carbon dioxide elimination (LCO 2 ) is a reflection of pulmonary capillary blood flow. It is hypothesized that as Zone 1 units form or V Dphys increases, LCO 2 decreases proportionately and eventually PaCO 2 increases. The purpose of this study is to determine if LCO 2 correlates with V Dphys during mechanical ventilation.Conclusion: CPAP increases Paw, which correlated positively with V Dphys . LCO 2 correlated negatively and PaCO 2 correlated positively with V D /V T . At V D /V T of approximately 0.5, LCO 2 began decreasing and PaCO 2 increasing. LCO 2 is simple to measure, and real time data provides useful clinical information, i.e., a noninvasive inference of changes in V Dphys and PaCO 2 following application of positive pressure.

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Section: Discussionmentioning

confidence: 99%