Time-varying respiratory elastance for spontaneously breathing patients

Yeong Shiong Chiew, Sarah F. Poole, Daniel P. Redmond, Erwin J. Van Drunen, Nor Salwa Damanhuri, Christopher Pretty, Paul D. Docherty, Bernard Lambermont, Geoffrey M. Shaw, Thomas Desaive, J. Geoffrey Chase

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

1 Citation (Scopus)

Abstract

Respiratory mechanics models can be used to optimise patient-specific mechanical ventilation (MV), but are limited to fully sedated MV patients who are not spontaneously breathing. This research presents a non-invasive model-based method to determine respiratory mechanics of spontaneously breathing MV patients. Patient-specific respiratory mechanics of 22 spontaneously breathing patients are described using a single compartment lung model with time-varying elastance (Edrs). The normalised Edrs trajectories and the area under the curves (AUCEdrs) are calculated using clinical data from 22 patients ventilated using pressure support (PS) and neurally adjusted ventilatory assist (NAVA). Edrs trajectories are also compared between ventilation modes. Edrs for PS ventilation were significantly higher compared to NAVA (p < 0.05). Edrs trajectories were more variable during NAVA than PS (p < 0.05). 20 of 22 patients had AUCEdrs > 25 cmH2Os/l. The AUCEdrs is a surrogate of elastance, and thus can be used as a respiratory failure severity indicator. This non-invasive model-based approach captures unique dynamic respiratory mechanics for spontaneously breathing patients during PS and NAVA. The model is fully general and is applicable to both fully controlled and partially assisted MV modes, with the resulting potential to standardise treatment for all MV patients.

Original languageEnglish
Title of host publication19th IFAC World Congress IFAC 2014, Proceedings
EditorsEdward Boje, Xiaohua Xia
PublisherElsevier - International Federation of Automatic Control (IFAC)
Pages5659-5664
Number of pages6
ISBN (Electronic)9783902823625
DOIs
Publication statusPublished - 2014
Externally publishedYes
EventInternational Federation of Automatic Control World Congress 2014 - Cape Town International Convention Centre, Cape Town, South Africa
Duration: 24 Aug 201429 Aug 2014
Conference number: 19th
http://www.ifac2014.org/

Publication series

NameIFAC Proceedings Volumes (IFAC-PapersOnline)
Volume19
ISSN (Print)1474-6670

Conference

ConferenceInternational Federation of Automatic Control World Congress 2014
Abbreviated titleIFAC 2014
CountrySouth Africa
CityCape Town
Period24/08/1429/08/14
Internet address

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