Validation and clinical feasibility of nitrogen washin/washout functional residual capacity measurements in children

Olegård, Cecilia; Søndergaard, Søren; Pålsson, Jan; Lundin, S.; Stenqvist, O.

doi:10.1111/j.1399-6576.2009.02107.x

Cited by 8 publications

(4 citation statements)

References 25 publications

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“…This is of interest insofar as current tidal volume setting guidelines are based on predicted body weight (PBW) and as such are relatively insensitive to the severity of lung injury. PBW scales with the size of the normal lung, but not with that of the injured lung [80,81]. Consequently, Chiumello et al .…”

Section: Effects Of Mechanical Ventilation On the Topographical Distrmentioning

confidence: 99%

The physical basis of ventilator-induced lung injury

Plataki

Hubmayr

2010

Expert Review of Respiratory Medicine

102

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Although mechanical ventilation (MV) is a life-saving intervention for patients with acute respiratory distress syndrome (ARDS), it can aggravate or cause lung injury, known as ventilator-induced lung injury (VILI). The biophysical characteristics of heterogeneously injured ARDS lungs increase the parenchymal stress associated with breathing, which is further aggravated by MV. Cells, in particular those lining the capillaries, airways and alveoli, transform this strain into chemical signals (mechanotransduction). The interaction of reparative and injurious mechanotransductive pathways leads to VILI. Several attempts have been made to identify clinical surrogate measures of lung stress/ strain (e.g., density changes in chest computed tomography, lower and upper inflection points of the pressure-volume curve, plateau pressure and inflammatory cytokine levels) that could be used to titrate MV. However, uncertainty about the topographical distribution of stress relative to that of the susceptibility of the cells and tissues to injury makes the existence of a single 'global' stress/strain injury threshold doubtful. Keywordsacute lung injury; acute respiratory distress syndrome; esophageal pressure; lung strain; lung stress; mechanical ventilation; mechanotransduction; plateau pressure; ventilator-induced lung injury Acute respiratory distress syndrome (ARDS), as defined by the American-European Consensus Conference Committee, is a syndrome of inflammation and increased permeability associated with acute onset of hypoxemia (partial arterial oxygen pressure/fractional inspired oxygen [PaO 2 /FiO 2 ] ≤200 mmHg) accompanied by bilateral infiltrates on chest radiograph that cannot be explained by, but may coexist with, left atrial or pulmonary capillary hypertension (pulmonary artery occlusion pressure ≤18 mmHg) [1]. The term acute lung injury (ALI) implies a milder degree of hypoxemia (PaO 2 /FiO 2 ≤300 mmHg) [1]. It was first described by Ashbaugh et al. in 1967 in 12 patients, seven (58%) of whom died [2]. Mechanical ventilation (MV) is an integral part of ARDS therapy, but like all treatments, inappropriate application can lead to side effects, namely ventilator-induced lung injury (VILI). To date, limiting VILI through lower tidal volumes is the only intervention proven to reduce mortality in ARDS [3]. Patients randomized to a lower tidal volume (6 ml/kg) ventilation strategy had a 22% relative reduction in mortality compared with patients receiving 12 ml/kg [3]. Although mortality in patients with ALI/ ARDS in large randomized controlled trials in the last decade

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Section: Effects Of Mechanical Ventilation On the Topographical Distrmentioning

confidence: 99%

The physical basis of ventilator-induced lung injury

Plataki

Hubmayr

2010

Expert Review of Respiratory Medicine

102

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“…The method is based on multibreath nitrogen washout, with an incremental change in Fio 2 of 0.1. Initially described by Olegard et al (13), subsequent studies have further validated the method both in vivo and in vitro and down to small infants (14,15). Measurement of FRC required between 3 and 5 minutes.…”

Section: Frc Measurement Proceduresmentioning

confidence: 97%

Inhaled β2-Agonist Therapy Increases Functional Residual Capacity in Mechanically Ventilated Children With Respiratory Failure*

Ramsi

Henry

Milla

et al. 2015

Pediatric Critical Care Medicine

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“…Mais du fait des modifications de la compliance thoracique avec la croissance, l'utilisation de la jaquette est difficile pour le suivi [18][19][20].…”

Section: Mesure Du Débit Maximal à La Capacité Résiduelle Fonctionnelleunclassified

Explorations fonctionnelles respiratoires et polysomnographies chez le nourrisson et l’enfant : aspects pratiques

Boulé

2015

Journal de Pédiatrie et de Puériculture

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Validation and clinical feasibility of nitrogen washin/washout functional residual capacity measurements in children

Abstract: FRC was satisfactorily measured by a modified N(2) algorithm and may be included as a monitoring variable in pediatric respiratory care. Pediatric FRC monitoring demands strictly stable conditions as measurements are performed close to the limits of the monitor's specifications.

Cited by 8 publications

References 25 publications

The physical basis of ventilator-induced lung injury

The physical basis of ventilator-induced lung injury

Inhaled β2-Agonist Therapy Increases Functional Residual Capacity in Mechanically Ventilated Children With Respiratory Failure*

Explorations fonctionnelles respiratoires et polysomnographies chez le nourrisson et l’enfant : aspects pratiques

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