Partitioning of work of breathing in mechanically ventilated COPD patients

Coussa, M. L.; Guérin, Claude; Eissa, N. Tony; Corbeil, C.; Chassé, M.; Braidy, J.; Matar, Nadim; Milic–Emili, J.

doi:10.1152/jappl.1993.75.4.1711

Cited by 110 publications

(65 citation statements)

References 25 publications

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“…In this respect, PEEPi acts as an inspiratory threshold load which increases the static elastic work of breathing. On average, it has been found that the inspiratory work due to PEEPi represents 57% of the overall increase in the work of breathing exhibited by COPD patients relative to normal subjects [62].…”

Section: Acute-on-chronic Respiratory Failurementioning

confidence: 99%

Respiratory failure

Roussos¹,

Koutsoukou²

2003

European Respiratory Journal

361

183

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Section: Acute-on-chronic Respiratory Failurementioning

confidence: 99%

Respiratory failure

Roussos¹,

Koutsoukou²

2003

European Respiratory Journal

361

183

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“…In patients capable of spontaneous breathing, intrinsic PEEP acts as an inspiratory threshold load and increases inspiratory WOB. 13,25 Intrinsic PEEP also impairs triggering of the ventilator, which would induce dissociation of the ventilator and the patient's breathing efforts. 13 Moreover, this dissociation would likely increase intrinsic PEEP by increasing P trach .…”

Section: Discussionmentioning

confidence: 99%

Estimation of Tracheal Pressure and Imposed Expiratory Work of Breathing by the Endotracheal Tube, Heat and Moisture Exchanger, and Ventilator During Mechanical Ventilation

et al. 2012

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BACKGROUND:The resistance of the endotracheal tube (ETT), the heat and moisture exchanger (HME), and the ventilator may affect the patient's respiratory status. Although previous studies examined the inspiratory work of breathing (WOB), investigation of WOB in the expiratory phase is rare. We estimated tracheal pressure at the tip of the ETT (P trach ) and calculated expiratory WOB imposed by the ETT, the HME, and the expiratory valve. We examined imposed expiratory WOB in patients under a continuous mandatory ventilation (CMV) mode and during spontaneous breathing trials (SBTs). We hypothesized that imposed expiratory WOB would increase with heightened ventilatory demand. METHODS: We measured airway pressure (P aw ) and respiratory flow (V ). We estimated P trach using the equation

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“…Accordingly, it is not surprising that, in COPD patients, MIP had a relatively high predictive power for weaning outcome, the ROC area amounting to 0.88 (table 4). COUSSA et al [5] predicted that COPD patients with ARF require a MIP of <35 cmH 2 O in order to be successfully weaned. In the present COPD patients, the MIP threshold value amounted to 44 cmH 2 O (table 4).…”

Section: Discussionmentioning

confidence: 99%

Predictors of weaning outcome in chronic obstructive pulmonary disease patients

Alvisi¹,

Volta²,

Er³

et al. 2000

Eur Respir J

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Several threshold values for predicting weaning outcome from mechanical ventilation have been proposed. These values, however, have been obtained in nonhomogeneous patient populations. The aim of the present study was to determine the threshold values in chronic obstructive pulmonary disease (COPD) patients and compare them to those reported for nonhomogeneous patient populations.The initial weaning trial included 81 COPD patients. Fifty-three of them underwent a successful weaning trial, whereas 28 failed it. The latter were enrolled into the present investigation, and were restudied during a subsequent successful trial. The weaning indices used were those reported in the literature.The threshold values obtained were within 10% of those reported for a nonhomogeneous patients population only for tidal volume and effective compliance. The classification error was <20% for maximal inspiratory pressure (MIP), occluded inspiratory pressure swing (DPI)/MIP, rapid and shallow breathing (respiratory frequency/tidal volume), and compliance, rate, oxygenation, pressure index (CROP), whereas the area under the receiver operating characteristic curves was >0.9 only for DPI/MIP and CROP.In conclusion, the threshold values obtained in chronic obstructive pulmonary disease patients who failed the first weaning attempt differed from those previously reported. Although a gold standard weaning index is not available for chronic obstructive pulmonary disease patients, the occluded inspiratory pressure swing/ maximal inspiratory pressure and compliance, rate, oxygenation, pressure index may be candidates for such a role. Eur Respir J 2000; 15: 656±662.

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Partitioning of work of breathing in mechanically ventilated COPD patients

Cited by 110 publications

References 25 publications

Respiratory failure

Respiratory failure

Estimation of Tracheal Pressure and Imposed Expiratory Work of Breathing by the Endotracheal Tube, Heat and Moisture Exchanger, and Ventilator During Mechanical Ventilation

Predictors of weaning outcome in chronic obstructive pulmonary disease patients

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