Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients

Anzueto, Antonio; Frutos‐Vivar, Fernando; Esteban, Andrés; Alía, Inmaculada; Brochard, Laurent; Stewart, Thomas E.; Benito, S.; Tobin, Martin J.; Elizalde, José; Pálizas, Fernando; David, Cide M.; Pimentel, Jorge; González, Marco; Soto, Luis; D’Empaire, Gabriel; Pelosi, Paolo

doi:10.1007/s00134-004-2187-7

Cited by 239 publications

(188 citation statements)

References 25 publications

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“…Black traces correspond to inspiratory phase and gray traces to expiratory phase In order to simulate the model, the values of α, β , R rs , E rs andṖ max were taken from [9] for healthy subjects. P max was set to 50 cmH 2 O because higher pressures can increase barotrauma risk both in healthy and pathological subjects [76,77]. Tab.…”

Section: (T) (L/s) T(s)mentioning

confidence: 99%

Novel Modeling of Work of Breathing for Its Optimization During Increased Respiratory Efforts

Higuita

Mañanas

Sánchez

et al. 2016

IEEE Systems Journal

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One of the most complex physiological systems whose modeling is still an open study is the respiratory control system where different models have been proposed based on the criterion of minimizing the work of breathing (WOB). The aim of this study is twofold: to compare two known models of the respiratory control system which set the breathing pattern based on quantifying the respiratory work; and to assess the influence of using direct-search or evolutionary optimization algorithms on adjustment of model parameters. This study was carried out using experimental data from a group of healthy volunteers under CO 2 incremental inhalation, which were used to adjust the model parameters and to evaluate how much the equations of WOB follow a real breathing pattern. This breathing pattern was characterized by the following variables: tidal volume, inspiratory and expiratory time duration and total minute ventilation. Different optimization algorithms were considered to determine the most appropriate model from physiological viewpoint. Algorithms were used for a double optimization: firstly, to minimize the WOB and secondly to adjust model parameters. The performance of optimization algorithms was also evaluated in terms of convergence rate, solution accuracy and precision. Results showed strong differences in the performance of opti- mization algorithms according to constraints and topological features of the function to be optimized. In breathing pattern optimization, the sequential quadratic programming technique (SQP) showed the best performance and convergence speed when respiratory work was low. In addition, SQP allowed to implement multiple non-linear constraints through mathematical expressions in the easiest way. Regarding parameter adjustment of the model to experimental data, the evolutionary strategy with covariance matrix and adaptation (CMA-ES) provided the best quality solutions with fast convergence and the best accuracy and precision in both models. CMAES reached the best adjustment because of its good performance on noise and multi-peaked fitness functions. Although one of the studied models has been much more commonly used to simulate respiratory response to CO 2 inhalation, results showed that an alternative model has a more appropriate cost function to minimize WOB from a physiological viewpoint according to experimental data.

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Section: (T) (L/s) T(s)mentioning

confidence: 99%

Novel Modeling of Work of Breathing for Its Optimization During Increased Respiratory Efforts

Higuita

Mañanas

Sánchez

et al. 2016

IEEE Systems Journal

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“…The development of barotrauma is associated with an increased ICU length of stay and an increased mortality rate [5].…”

Section: Discussionmentioning

confidence: 99%

Pneumothorax, Pneumomediastinum, Pneumoperitoneum and Surgical Emphysema in Mechanically Ventilated Patients

Kamha

Alzeer

Elithy

2008

Libyan Journal of Medicine

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A 29 year old male patient of Indian ancestry was admitted to an outside hospital with rapid deterioration of his level of consciousness. The patient required mechanical ventilation and transfer to MICU at Hamad Medical Corporation. The patient remained hypoxic. Chest X-ray, CT of chest, abdomen, pelvis and proximal areas of both lower limbs were performed. Pneumomediastinum, pneumoperitoneum, and extensive surgical emphysema were the diagnoses.

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“…Therefore, increasing the frequency of breaths in order to maintain adequate minute ventilation while at the same time minimizing tidal volume (TV) to the recommended values is another element of lung protective strategy. The recommended TV values for children are similar to those for adults and should amount to about 6 mL/kg of body weight [25][26][27].…”

Section: Lung Protective Ventilationmentioning

confidence: 95%

Mechanical Ventilation in Children – Problems and Issues

Zielińska

Zieliński

Sniatkowska-Bartkowska

2014

Adv Clin Exp Med

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Respiratory failure is the leading reason for the admission of children to intensive care units, and the ventilator is the main therapeutic tool used during the treatment of these patients. A competently used ventilator and adequate knowledge of the anatomy, histology and physiology of the respiratory system in particular age groups of children (especially among neonates and infants) are crucial for successful treatment. Both non-invasive and invasive ventilation modes can be used for respiratory treatment in children. Invasive ventilation modes can be divided into two groups: conventional ones such as pressure-controlled or volume-controlled ventilation, or non-conventional modes such as oscillatory ventilation. Mechanical ventilation can involve a high risk of serious complications, such as pressure injury (barotrauma), volume injury (volutrauma) and biotrauma. Adhering to the principles of lung-protective ventilation can reduce the risk of side effects of mechanical ventilation (Adv Clin Exp Med 2014, 23, 5, 843-848).

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Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients

Abstract: In a cohort of patients in whom airway pressures and tidal volume are limited, barotrauma is more likely in patients ventilated due to underlying lung disease (acute or chronic). Barotrauma was also associated with a significant increase in the ICU length of stay and mortality.

Cited by 239 publications

References 25 publications

Novel Modeling of Work of Breathing for Its Optimization During Increased Respiratory Efforts

Novel Modeling of Work of Breathing for Its Optimization During Increased Respiratory Efforts

Pneumothorax, Pneumomediastinum, Pneumoperitoneum and Surgical Emphysema in Mechanically Ventilated Patients

Mechanical Ventilation in Children – Problems and Issues

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