Negative lung elastance in mechanically ventilated spontaneously breathing patient

Nor Salwa Damanhuri, Yeong Shiong Chiew, Paul D. Docherty, Nor Azlan Othman, Geoffrey M. Shaw, Thomas Desaive, J. Geoffrey Chase

Research output: Chapter in Book/Report/Conference proceedingConference PaperOther

4 Citations (Scopus)

Abstract

Mathematical modelling of respiratory system can guide clinicians in better monitoring and decision making for mechanically ventilated (MV) patients in intensive care unit (ICU). However, most mathematical models are develop for fully sedated patients and not particularly reliable to be applied for spontaneous breathing (SB) patients. Monitoring respiratory mechanics of SB patients requires invasive clinical protocols and equipment that are clinically too intensive to carry out. Previous study hypothesized that negative elastance occurred in SB patients due to the SB effort produced by the patient. Thus, this paper aims to further investigate the distribution of negative elastance in SB patients by extending the noninvasive time-varying elastance model. By capturing and reviewing the distribution of the negative elastance in SB patient, it can provide more consistent monitoring and decision making particularly for SB patients. Clinical data from 5 MV patients from Christchurch Hospital were used in this study. The area under the curve (AUC) for the time-varying elastance, Edrs, is estimated and analysed in each SB patient. The results are reported as median and interquartile range (IQR) for continuous data with a total of 82 hours. From the result, it was found that all patients have distribution of negative elastance with Patients 1 and 3 have higher distribution of negative elastance due to the SB effort. The median vaue for the negative elastance for all patients’ ranges from -0.66 cmH20.s/l to -2.27 cmH20.s/l. Negative elastance occurs when negative pressure is generated in the patient's pleural space causing air volume to enter the lung. Thus, by capturing and reviewing the distribution of the negative elastance in SB patient, it can provide more consistent monitoring and decision making particularly for SB patients.

Original languageEnglish
Title of host publication20th IFAC World Congress
PublisherElsevier - International Federation of Automatic Control (IFAC)
Pages15179-15184
Number of pages6
Volume50
Edition1
DOIs
Publication statusPublished - 2017
Externally publishedYes
EventInternational Federation of Automatic Control World Congress 2017 - Toulouse, France
Duration: 9 Jul 201714 Jul 2017
Conference number: 20th
https://www.ifac2017.org/

Conference

ConferenceInternational Federation of Automatic Control World Congress 2017
Abbreviated titleIFAC 2017
Country/TerritoryFrance
CityToulouse
Period9/07/1714/07/17
Internet address

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