Measurement of transdiaphragmatic pressure with a single gastric-esophageal probe

Gilbert, Robert; Peppi, David; Auchincloss, J. Howland

doi:10.1152/jappl.1979.47.3.628

Cited by 20 publications

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“…Diaphragmatic contractility and evaluation of P di with balloon catheters is a subject, which has been investigated in fatigued, intact diaphragm after electrical stimulation of the phrenic nerves in human patients [16], [21], [36]. It is reported that the P di value during a normal sniff is more than 58.84 mmHg in men and more than 51.49 mmHg in women [37].…”

Section: Discussionmentioning

confidence: 99%

“…Although POPE can be developed in a few minutes in patients under anaesthesia, there is no reference to the development of POPE in dogs under anaesthesia in clinical setting. Additionally, POPE has not been reported in any clinical study in awake patients for the P di measurement with the application of the Mueller’s manoeuvre [20], [21], [22], [23]. Clinical signs of POPE are tachypnoea, tachycardia and rhonchi, and chest radiographs may confirm pulmonary edema [39].…”

Section: Discussionmentioning

confidence: 99%

“…P di is defined as the difference between the intra-abdominal (P abd ) and the intra-pleural (P pl ) pressure [20], [21], [22]. However, the measurement of P abd and P pl is not straightforward under clinical conditions and alternative less invasive techniques have been considered, substituted the measurement of P abd and P pl by the measurement of the pressure in the stomach (P gast ) and in the oesophagus (P oes ), respectively [23].…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Four Anaesthetic Protocols for Maintenance of Anaesthesia on Trans-Diaphragmatic Pressure in Dogs

et al. 2013

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The diaphragm is the main inspiratory muscle and the main indicator of diaphragmatic contractility is the trans-diaphragmatic pressure (Pdi). The aim of this clinical study was to determine the effect of four different anaesthetic protocols on Pdi in anaesthetized healthy dogs. Eighty client-owned dogs were recruited in this clinical study. All the animals received dexmedetomidine and morphine as premedication and propofol for induction. Anaesthesia was maintained with one of four protocols: isoflurane (I), isoflurane with CRI of propofol (IP), isoflurane with CRI of fentanyl (IF), and isoflurane with CRI of ketamine (IK). When the surgical plane of anaesthesia was achieved, two balloon catheters were inserted, one into the stomach and one into the mid-third of the oesophagus for Pdi measurement. Pdi value was the highest in groups I (14.9±4.7 mmHg) and IK (15.2±3.5 mmHg) and the lowest in groups IP (12.2±3.2 mmHg) and IF (12.0±5.9 mmHg). There was a statistically significant difference (p = 0.029) between groups IK and IF. PE’CO2 was statistically significantly higher (p<0.0005) in group IF (7.7±0.8 kPa) than in group IK (6.5±0.7 kPa). Isoflurane alone or isoflurane with ketamine for the maintenance of anaesthesia seem to better preserve the respiratory function and the diaphragmatic contractility than isoflurane with either propofol or fentanyl in dogs. Therefore, the use of isoflurane or isoflurane with ketamine may be of benefit when animals with respiratory problems have to be anaesthetized.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effect of Four Anaesthetic Protocols for Maintenance of Anaesthesia on Trans-Diaphragmatic Pressure in Dogs

et al. 2013

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“…The conventional method for making these measurements, with balloon catheters, is uncomfortable, and not tolerated by some patients. In particular, these measurements can seldom be performed in acutely breathless or ill patients [2]. There is a need for an alternative method that is more easily tolerated.…”

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confidence: 99%

An in vivo comparison of a catheter mounted pressure transducer system with conventional balloon catheters

Stell¹,

Tompkins²,

Lovell³

et al. 1999

Eur Respir J

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An in vivo comparison of a catheter mounted pressure transducer system with conventional balloon catheters. I.M. Stell, S. Tompkins, A.T. Lovell, J.C. Goldstone, J. Moxham. #ERS Journals Ltd 1999. ABSTRACT: In the assessment of respiratory muscle function balloon catheters have been widely used for pressure measurements. However, this type of investigation is poorly tolerated by acutely ill patients. This study assessed the performance of a possible alternative, a catheter-mounted miniature pressure transducer (CMT).The assessment consisted of a laboratory study of the linearity, frequency response, and stability of gain and baseline of the CMT system, and an in vivo study directly comparing the CMT and balloon catheter systems in seven normal subjects for a range of respiratory manoeuvres. These were: 1) maximal inspiratory and expiratory pressures against a closed airway, 2) twitch transdiaphragmatic pressure elicited by cervical magnetic phrenic nerve stimulation, and 3) tidal breathing, sniffs and coughs in five body positions. The agreement of the two systems was analysed for measurements of 1) absolute pressures, 2) magnitude of changes in pressure, and 3) rate of change of pressure (maximum relaxation rate after sniff manoeuvres).The CMT system was linear, with a high frequency response and stable gain, but showed baseline drift. The two systems agreed well for measurements of change and rate of change of pressure, but less well for measurements of absolute pressure.The CMT system tested is potentially useful for studies of acute changes in respiratory pressures, or studies of respiratory muscle strength, but would be less useful where accurate measurements of absolute pressures are required.

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“…Convential recording of EMGdj signal can be done in two ways: (i) insertion of needle electrode in the diaphragm with the risk of lung perforation [3], and (ii) multiple electrodes built-in a catheter, inserted in the oesophageal conduit [4,5] and centered in the gastrooesophageal sphincter. The recorded EMGd, is contaminated by the electrical activity of the heart (ECG).…”

Section: Introductionmentioning

confidence: 99%

A comparative study of EMG/sub di/ recording electrodes

Awada

Dido

Bellemare

CCECE 2003 - Canadian Conference on Electrical and Computer Engineering. Toward a Caring and Humane Technology (Cat. No.03CH374

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Electromyographic recording of the diaphragm (EMGdJ have been used to evaluate its finctionalig and its fatigue. This signal is contaminated by the electrical activity of the heart, movement of diaphragm and lung volume change. Conventional recording of EMGdI signal can be achieved in two main ways:(i) insertion of needle electrode in the diaphragm with the risk of lung perjoration, and (ii) using an array of electrodes built in a catheter that can be inserted in the oesophageal conduit and centered in the gastro-oesophageal sphincter. Usually ECG signal overlaps EMGd, signal in a large hand of its spectrum. Several methods were proposed in order to eliminate the ECG signals such as high pass and LMS adaptive filters. In this project we model and simulate the finctionaliq of two gpes of recording electrodes, and to veri& the effect of artefacts on EMGd, signal. The model comists of (ij 30 block filled with air with zero potential at its boundaries, (iij a point source of fuedpotential and variable position, and (iii) an array of electrodes. The potential distribution on the electrodes w a obtained by solving Laplace equation using finite element method. Our simulation results on examined types of electrode geometries showed a reduction of interjerence signals generated by the ECG and other EMG muscles on the EMGdz when ring electrodes were used. More complex geometries are currently under investigation in order to explore the reduction of contamination.

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Measurement of transdiaphragmatic pressure with a single gastric-esophageal probe

Cited by 20 publications

References 0 publications

The Effect of Four Anaesthetic Protocols for Maintenance of Anaesthesia on Trans-Diaphragmatic Pressure in Dogs

The Effect of Four Anaesthetic Protocols for Maintenance of Anaesthesia on Trans-Diaphragmatic Pressure in Dogs

An in vivo comparison of a catheter mounted pressure transducer system with conventional balloon catheters

A comparative study of EMG/sub di/ recording electrodes

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