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- W2023671672 abstract "Background: Lung mechanics are usually measured using static or quasistatic methods, abandoning normal ventilatory treatment. We have developed a method to calculate the alveolar pressure during dynamic/therapeutic conditions, “the dynostatic pressure” (Pdyn), using airway pressure (P) measured in the trachea and volume (V) and flow (V˙) at the Y-piece. Methods: Pdyn is calculated according to the formula Pdyn=(Pinsp×V˙exp–Pexp×V˙insp)/(V˙exp–V˙insp), making the assumption that inspiratory and expiratory resistances are equal at isovolume. The method was evaluated in a lung model during dynamic conditions comparing measured alveolar pressure (Palv) and Pdyn at equal and unequal inspiratory and expiratory resistances and P/V-curves obtained during static and dynamic conditions. The algorithm was then applied in patients with acute lung injury (ALI). Results: When inspiratory and expiratory resistances were equal there was an excellent agreement between the Pdyn and the Palv, irrespective of ventilator settings, r2=0.995 (range 0.981–0.999). Pdyn derived compliance was equal to static values. When the ratio between inspiratory and expiratory resistance was varied between 2.3:1 and 1:2.3 the r2 was above 0.95 (range 0.952–0.996). Development of intrinsic PEEP and overdistension was easily revealed in patients, as shown by the dynostatic P/V-curve. Conclusion: The dynostatic method gives a breath-by-breath reflection of the interaction between ventilatory settings and lung mechanics in patients during ordinary ventilator treatment. It is only marginally affected by the moderate differences in inspiratory versus expiratory resistances present in patients with ALI." @default.
- W2023671672 created "2016-06-24" @default.
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- W2023671672 date "2000-05-01" @default.
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- W2023671672 title "A new method for non-invasive, manoeuvre-free determination of static pressure-volume curves during dynamic/therapeutic mechanical ventilation" @default.
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- W2023671672 doi "https://doi.org/10.1111/j.1399-6576.2000.00516.x" @default.
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