Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction

Chiew, Yeong Shiong; Tan, Chee Pin; Chase, J. Geoffrey; Chiew, Yeong Woei; Desaive, Thomas; Ralib, Azrina; Nor, Mohd Basri Mat

doi:10.1016/j.cmpb.2018.02.007

Cited by 38 publications

(18 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Chiew et al 37 used an iterative airway pressure reconstruction algorithm to represent asynchronous airway pressure waveforms to better match passive breathing airway waveforms using a single compartment model. The reconstructed pressure enabled estimation of the respiratory mechanics of an airway pressure waveform essentially free from asynchrony.…”

Section: Automated Detection Of Synchrony Problemsmentioning

confidence: 99%

2019 Year in Review: Patient-Ventilator Synchrony

Chatburn

Mireles-Cabodevila

2020

Respir Care

View full text Add to dashboard Cite

Patient-ventilator synchrony is a popular topic of research on mechanical ventilation. This review puts this research into both contemporary and historical perspective. Five areas of research are described: literature reviews, manual detection of synchrony problems, automated detection of synchrony problems, modes for improving synchrony, and effects of sedation. We note that this type of research lacks a standardized vocabulary and associated taxonomy, which generates difficulty in communication among students and researchers, as well as in comparison of results. Hence, we conclude this paper with some suggestions for improvement in that regard.

show abstract

Section: Automated Detection Of Synchrony Problemsmentioning

confidence: 99%

2019 Year in Review: Patient-Ventilator Synchrony

Chatburn

Mireles-Cabodevila

2020

Respir Care

View full text Add to dashboard Cite

show abstract

“…Patientventilator asynchrony severely interfere with MV 25,[27][28][29] and is associated with prolonged MV 25 . For this reason, it can be much harder to detect and/or reduce ventilator asynchrony in the NICU setting in comparison to adult ICU 25,28 . Neonates may thus require much closer and more frequent attention to ventilator settings and response for this reason as well to minimise asynchrony and further enhance patient-ventilator interaction.…”

Section: Asynchronymentioning

confidence: 99%

Mechanically ventilated premature babies have sex differences in specific elastance: A pilot study

Kim

Knopp

Dixon

et al. 2019

Pediatric Pulmonology

Self Cite

View full text Add to dashboard Cite

Objectives:A pilot study to compare pulmonary mechanics in a NICU cohort, specifically, comparing lung elastance between male and female infants in the neonatal ICU (NICU).Hypothesis: Anecdotally, male infants are harder to ventilate than females. We hypothesise that males have higher model-based elastance (converse: lower specific compliance) compared to females, reflecting underlying stiffer lungs. Study design:A clinically validated, single compartment model is used to identify specific elastance (inverse of specific compliance) and resistance for each breath. Specific elastance accounts for weight differences when comparing male and female infants. Relative percent breath-to-breath variability (%ΔE) in specific elastance is also compared. Level of asynchrony was determined. Patient-subject selection: 10 invasively mechanically ventilated patients from ChristchurchWomen's Hospital.Methodology: Airway pressure and flow data from 10 invasive MV infants from Christchurch Women's Hospital Neonatal Intensive Care Unit, New Zealand was prospectively recorded under standard MV care. Model-based specific elastance and resistance are identified for each breath, as well as relative percent breath-to-breath variability (%ΔE) in specific elastance. Results: Male infants overall had higher specific elastance compared to females infants (p ≤ 0.01), with median [interquartile range (IQR)] for males of 1.91[1.33-2.48]cmH2O.kg/ml compared to 1.31[0.86-2.02]cmH2O.kg/ml in females. Male infants had lower variability with %ΔE of -0.03[-7.56 -8.01]% versus female infants of -0.59[12.56 -12.86]%. Males had 14.75% asynchronous breaths whereas females had 17.54%.Conclusion: Overall, males had higher specific elastance and correspondingly lower breathto-breath variability. These results indicate male and female infants may require different MV settings, modes and monitoring.

show abstract

“…Due the SB effort produced by the MV patients even if sedated, it thus creates a significantly lower identified lung elastance, which inaccurately measure the respiratory mechanics of MV patients. Thus, with pressure reconstruction model, it helps to reconstruct the missing pressure and able to estimate the true underlying respiratory mechanics of SB patients as shown in Figure 3 [14,23].…”

Section: Pressure Reconstruction Modelmentioning

confidence: 99%

“…As shown in Figure 4, A1 is defined as the area of the entrained pressure waveform which has lower overall time varying elastance (AUC Edrs) compared to the reconstructed waveform [14,23]. The value of elastance could be led higher with an addition of A2 which is defined as the area of missing pressure.…”

Section: Estimation Of Spontaneous Breathing Effortmentioning

confidence: 99%

Assessing SB effort via a non-invasive model-based method in mechanically ventilated patients in Malaysian ICU hospital

Damanhuri

Ariffin

Othman

et al. 2019

IJEECS

View full text Add to dashboard Cite

Patients with Acute Respiratory Distress Syndrome (ARDS) required mechanical ventilation (MV) for breathing support. However, some MV patients encountered spontaneous breathing (SB) efforts while fully sedated which can obscure the true underlying respiratory mechanics of these patients. Thus, a model-based method is required to reconstruct the missing pressure and calculate the breathing effort that produced by the patients without additional clinical protocols or invasive procedure. In this paper, results of spontaneous breathing effort in Malaysian critically-ill patients adopting the developed pressure reconstruction model are presented. By using the pressure reconstruction model, the SB affected pressure waveform is reconstructed to approximate true respiratory mechanics and quantifies the SB effort. The SB breathing efforts were computed and compared with the results from Christchurch Hospital, New Zealand. The substitute measure of SB effort can be indicated from the difference between the reconstructed and unreconstructed pressure. Results shows that all patients from both cohorts exhibited SB effort with the highest SB effort at 11.48% for Malaysian patient and 21.07% for Christchurch patient. Overall, the well-developed non-invasive pressure reconstruction method is able to measure the SB effort produced by Malaysian MV patients that help the clinicians in selecting the optimal MV setting. This first non-invasive guidance in selecting the optimal setting of MV in Malaysia is potentially reduced the ICU cost and improve the MV management in Malaysian hospital.

show abstract

Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction

Cited by 38 publications

References 32 publications

2019 Year in Review: Patient-Ventilator Synchrony

2019 Year in Review: Patient-Ventilator Synchrony

Mechanically ventilated premature babies have sex differences in specific elastance: A pilot study

Assessing SB effort via a non-invasive model-based method in mechanically ventilated patients in Malaysian ICU hospital

Contact Info

Product

Resources

About