Assessing respiratory mechanics using pressure reconstruction method in mechanically ventilated spontaneous breathing patient

Damanhuri, Nor Salwa; Chiew, Yeong Shiong; Othman, Nor Azlan; Docherty, Paul; Pretty, Christopher G.; Desaive, Thomas; Chase, J. Geoffrey

doi:10.1016/j.cmpb.2016.03.025

Cited by 36 publications

(19 citation statements)

References 31 publications

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“…Pressure recontruction model was first developed by Damanhuri et. al [14]. 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.…”

Section: Pressure Reconstruction Modelmentioning

confidence: 99%

“…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%

“…Damanhuri et. al has developed a pressure reconstruction model that is able to assses the breathing effort in SB ventilated patients without additional tools and protocol by using the Christchurch Hospital data [14]. Hence, this study aims to assess, evaluate and compare the SB ventilated patients in Malaysian ICU setting, International Islamic University (IIUM) Hospital against Christchurch Hospital, New Zealand.…”

Section: Introductionmentioning

confidence: 99%

“…Figure 1. Differentiation of (left) a normal airway pressure waveform with good model fitting to (right) an airway pressure waveform with breathing effort that leads to a poor model fit to the pressure waveform [14]…”

Section: Introductionmentioning

confidence: 99%

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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

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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.

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Section: Pressure Reconstruction Modelmentioning

confidence: 99%

Section: Pressure Reconstruction Modelmentioning

confidence: 99%

Section: Estimation Of Spontaneous Breathing Effortmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

Self Cite

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Generative Adversarial Network in Reconstructing Asynchronous Breathing Cycle

et al. 2021

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Model Iterative Airway Pressure Reconstruction During Mechanical Ventilation Asynchrony: Shapes and Sizes of Reconstruction

et al. 2017

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Model-based methods estimating patient-specific respiratory mechanics may help intensive care clinicians in setting optimal ventilation parameters. However, these methods rely heavily on the quality of measured airway pressure and flow profiles for reliable respiratory mechanics estimation. Thus, asynchronous and/or spontaneous breathing cycles that do not follow a typical passive airway profile affect the performance and reliability of model-based methods. In this study, a model iterative airway pressure reconstruction method is presented. It aims to reconstruct a measured airway pressure affected by asynchronous breathing iteratively, trying to match the profile of passive breaths with no asynchrony or spontaneous breathing effort. Thus, reducing the variability of identified respiratory mechanics over short time periods where changes would be due only to asynchrony or spontaneous artefacts. A total of 2000 breathing cycles from mechanically ventilated patients with known asynchronous breathing were analyzed. It was found that this method is capable of reconstructing an airway pressure free from asynchronous or spontaneous breathing effort. This work focuses on several cases, detailing how iterative pressure reconstruction method performs under different cases, as well as its limitation.

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Assessing respiratory mechanics using pressure reconstruction method in mechanically ventilated spontaneous breathing patient

Cited by 36 publications

References 31 publications

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

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

Generative Adversarial Network in Reconstructing Asynchronous Breathing Cycle

Model Iterative Airway Pressure Reconstruction During Mechanical Ventilation Asynchrony: Shapes and Sizes of Reconstruction

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