Lung elastance and transpulmonary pressure can be determined without using oesophageal pressure measurements

Stenqvist, O.; Grivans, Christina; Andersson, Bertil; Lundin, S.

doi:10.1111/j.1399-6576.2012.02696.x

Cited by 34 publications

(43 citation statements)

References 28 publications

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“…As we analyzed data of lung volume measurements from earlier studies with a different research question, the study design has some limitations: Firstly, we did not measure esophagus pressures in the present study and compared our data with previous published data 6, 13. Secondly, Stenqvist et al.…”

Section: Discussionmentioning

confidence: 96%

“…Therefore, there is a need for an easy to use method to calculate transpulmonary pressure. Recently, Stenqvist et al 6. proposed a method to calculate transpulmonary pressures based on non‐invasive EELV measurements, during an incremental PEEP trial.…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, Stenqvist et al. calculated specific elastance6 during an incremental PEEP trial, whereas we performed a decremental PEEP trial. In a recent experimental study20, we performed an incremental and decremental PEEP trial in healthy and ARDS lungs.…”

Section: Discussionmentioning

confidence: 99%

“…recently developed a technique to calculate elastance without the use of transpulmonary pressure measurements by using EELV measurements. They showed6 that calculating elastance from EELV measurements correlates very well with elastance calculated from esophageal pressure measurements ( r 2 = 0.96) in patients with moderate or severe respiratory failure. For patients with pulmonary and extrapulmonary Acute Respiratory Distress Syndrome (ARDS), this comparison resulted in a r 2 = 0.99.…”

Section: Introductionmentioning

confidence: 98%

“…Stenqvist et al 6. recently developed a technique to calculate elastance without the use of transpulmonary pressure measurements by using EELV measurements.…”

Section: Introductionmentioning

confidence: 99%

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Lung stress and strain calculations in mechanically ventilated patients in the intensive care unit

Blankman

Hasan

Bikker

et al. 2015

Acta Anaesthesiol Scand

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BackgroundStress and strain are parameters to describe respiratory mechanics during mechanical ventilation. Calculations of stress require invasive and difficult to perform esophageal pressure measurements. The hypothesis of the present study was: Can lung stress be reliably calculated based on non‐invasive lung volume measurements, during a decremental Positive end‐expiratory pressure (PEEP) trial in mechanically ventilated patients with different diseases?MethodsData of 26 pressure‐controlled ventilated patients admitted to the ICU with different lung conditions were retrospectively analyzed: 11 coronary artery bypass graft (CABG), 9 neurology, and 6 lung disorders. During a decremental PEEP trial (from 15 to 0 cmH2O in three steps) end‐expiratory lung volume (EELV) measurements were performed at each PEEP step, without interruption of mechanical ventilation. Strain, specific elastance, and stress were calculated for each PEEP level. Elastance was calculated as delta PEEP divided by delta PEEP volume, whereas specific elastance is elastance times the FRC. Stress was calculated as specific elastance times the strain. Global strain was divided into dynamic (tidal volume) and static (PEEP) strain.ResultsStrain calculations based on FRC showed mainly changes in static component, whereas calculations based on EELV showed changes in both the static and dynamic component of strain. Stress calculated from EELV measurements was 24.0 ± 2.7 and 13.1 ± 3.8 cmH2O in the lung disorder group at 15 and 5 cmH2O PEEP. For the normal lungs, the stress values were 19.2 ± 3.2 and 10.9 ± 3.3 cmH2O, respectively. These values are comparable to earlier publications. Specific elastance calculations were comparable in patients with neurologic and lung disorders, and lower in the CABG group due to recruitment in this latter group.ConclusionStress and strain can reliably be calculated at the bedside based on non‐invasive EELV measurements during a decremental PEEP trial in patients with different diseases.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

“…Stenqvist et al 6. recently developed a technique to calculate elastance without the use of transpulmonary pressure measurements by using EELV measurements.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations