Determination of volume-dependent respiratory system mechanics in mechanically ventilated patients using the new SLICE method

Guttmann, J.; Eberhard, L.; Fabry, Ben; Zappe, D.; Bernhard, H.; Lichtwarck-Aschoff, Michael; Adolph, M.; Wolff, G.

doi:10.3233/thc-1994-2302

Cited by 82 publications

(40 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The respective volume-dependent compliance profile was calculated using the gliding-SLICE method. 7,9,10 In brief, of the intratidal pressure-volume curve, 31 equidistant volume sections (slices) were defined, including the volume range of 1/6th of the tidal volume. For each slice, the volume specific compliance was determined via multiple linear regression analysis of data lying within the slice.…”

Section: Discussionmentioning

confidence: 99%

“…6 The analysis of intratidal compliance appears to be appropriate for achieving this aim. 7 The purpose of the current study was to characterize the individual changes in intratidal respiratory mechanics of patients with healthy lungs during standardized gradual increases of PEEP. For this reason, the respiratory system mechanics were analysed using the gliding-SLICE method and regional ventilation was measured using electrical impedance tomography (EIT).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intraoperative compliance profiles and regional lung ventilation improve with increasing positive end‐expiratory pressure

Wirth

Kreysing

Spaeth

et al. 2016

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

We conclude that in most patients, the often applied PEEP of 5 cm H2 O is insufficient to prevent intratidal recruitment/derecruitment and that few patients show overdistension at high PEEP levels. To establish optimal pressure-volume relationships in the respiratory system, the analysis of the individual intratidal compliance profiles could be a means for individualized perioperative PEEP titration.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intraoperative compliance profiles and regional lung ventilation improve with increasing positive end‐expiratory pressure

Wirth

Kreysing

Spaeth

et al. 2016

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…To analyze the pressure-volume curve we used a modified SLICE-method. 18 This method analyzes the pressurevolume relationship for discrete volume intercepts and calculates compliance values by multiple linear regression analysis. As constant flow was applied during inflation, the compliance can be derived from the slope of the ascending limb of the pressure-volume curve.…”

Section: Pressure-volume Relationship Under Dynamic Conditionsmentioning

confidence: 99%

Contact‐free determination of material characteristics using a newly developed pressure‐operated strain‐applying bioreactor

et al. 2008

Self Cite

View full text Add to dashboard Cite

Experimental mechanostimulation of biologic samples serves to understand fundamental processes in mechanobiology. Unfortunately, present techniques do not allow contact-free investigation of material characteristics. We developed a mechanostimulator that functions under the assumption that the counterforce generated by a biologic sample placed on a carrier membrane (test-on-carrier) is extractable from the total signal. As material characteristics of biologic samples are poorly defined, we substituted them by polyurethane and latex membranes. Based on the knowledge of the previously measured carrier membrane's compliance, we calculated the test membrane's compliance from the pressure-volume relationship inside the bioreactor. We hypothesized that knowing the carrier membranes' compliance allows calculation of the sample's compliance. Compliances of latex membranes were larger than those of polyurethane ones (p < 0.05). The average differences between calculated and directly determined compliances were 3.9% +/- 2.7% and 6.7% +/- 4.8% (mean +/- SD) under static and dynamic mechanostimulation, respectively (p > 0.05). The variability of compliance values was several fold larger (p < 0.01) for latex-on-polyurethane compared to polyurethane-on-latex combinations. There was high correlation between Young's modulus as determined from static compliance estimation and by uniaxial stretching in a tension-testing machine (r(2) = 0.987, p < 0.001). In conclusion, our mechanostimulator allowed reliable contact-free determination of material characteristics and may thus be suitable for contact-free assessment of biologic samples. The compliance of the carrier membrane should be at least two times larger than the compliance of the tested material.

show abstract

“…However, a single compliance value cannot reflect the non-linearity of intratidal respiratory system mechanics during the breathing cycle [14,15]. To cope with the non-linearity of the intratidal C RS under the dynamic conditions of mechanical ventilation, the gliding-SLICE method [16,17] was introduced, enhancing the classical SLICE method [18,19]. To evaluate the intratidal C RS with the enhanced gliding-SLICE method, the pressure-volume curve is subdivided into several volume steps, and the volume-dependent compliance is calculated on the base of data points within a certain volume range ('slice') around the current step via multiple linear regression analysis (Fig.…”

Section: Introductionmentioning

confidence: 99%

Effect of individualized PEEP titration guided by intratidal compliance profile analysis on regional ventilation assessed by electrical impedance tomography – a randomized controlled trial

et al. 2020

View full text Add to dashboard Cite

Background: The application of positive end-expiratory pressure (PEEP) may reduce dynamic strain during mechanical ventilation. Although numerous approaches for PEEP titration have been proposed, there is no accepted strategy for titrating optimal PEEP. By analyzing intratidal compliance profiles, PEEP may be individually titrated for patients.Methods: After obtaining informed consent, 60 consecutive patients undergoing general anesthesia were randomly allocated to mechanical ventilation with PEEP 5 cmH 2 O (control group) or PEEP individually titrated, guided by an analysis of the intratidal compliance profile (intervention group). The primary endpoint was the frequency of each nonlinear intratidal compliance (C RS ) profile of the respiratory system (horizontal, increasing, decreasing, and mixed). The secondary endpoints measured were respiratory mechanics, hemodynamic variables, and regional ventilation, which was assessed via electrical impedance tomography.Results: The frequencies of the C RS profiles were comparable between the groups. Besides PEEP [control: 5.0 (0.0), intervention: 5.8 (1.1) cmH 2 O, p < 0.001], the respiratory and hemodynamic variables were comparable between the two groups. The compliance profile analysis showed no significant differences between the two groups. The loss of ventral and dorsal regional ventilation was higher in the control [ventral: 41.0 (16.3)%; dorsal: 25.9 (13.8)%] than in the intervention group [ventral: 29.3 (17.6)%; dorsal: 16.4 (12.7)%; p (ventral) = 0.039, p (dorsal) = 0.028]. Conclusions: Unfavorable compliance profiles indicating tidal derecruitment were found less often than in earlier studies. Individualized PEEP titration resulted in slightly higher PEEP. A slight global increase in aeration associated with this was indicated by regional gain and loss analysis. Differences in dorsal to ventral ventilation distribution were not found.Trial registration: This clinical trial was registered at the German Register for Clinical Trials (DRKS00008924) on August 10, 2015.

show abstract

Determination of volume-dependent respiratory system mechanics in mechanically ventilated patients using the new SLICE method

Cited by 82 publications

References 0 publications

Intraoperative compliance profiles and regional lung ventilation improve with increasing positive end‐expiratory pressure

Intraoperative compliance profiles and regional lung ventilation improve with increasing positive end‐expiratory pressure

Contact‐free determination of material characteristics using a newly developed pressure‐operated strain‐applying bioreactor

Effect of individualized PEEP titration guided by intratidal compliance profile analysis on regional ventilation assessed by electrical impedance tomography – a randomized controlled trial

Contact Info

Product

Resources

About