Comparison of automated and static pulse respiratory mechanics during supported ventilation

Alpesh Patel, Susan Taylor, Andrew Bersten

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    Abstract

    Objective: To compare respiratory mechanics estimated by the pulse technique in spontaneously breathing patients during proportional assist ventilation (PAV) with loadadjustable gain factor (PAV+) mode with those measured using the flow-interruption technique during controlled ventilation. Design, participants and setting: Observational study of 21 haemodynamically stable post-cardiac surgery patients with routine weaning from mechanical ventilation (Puritan- Bennett 840 ventilator) in the intensive care unit of a tertiary hospital. Main outcome measures: Bland-Altman and linear correlation of respiratory system compliance and inspiratory resistance estimated during PAV+ (C pulse and R pulse ) with that measured during controlled mechanical ventilation (C int and R int ). Results: C pulse overestimated C int (67.4 [SD, 27.7] v 51.6 [SD, 9.7] mL/cmH 2 O; P = 0.02), although the correlation between C int and C pulse was strong. Using the Bland-Altman method, the bias and limits of agreement were outside a clinically useful range. R pulse underestimated R int (9.3 [SD, 3.0] v 11.5 [SD, 3.0] cmH 2 O/L/s; P = 0.02), with a weak positive correlation. Although the bias calculated by the Bland-Altman method was small, the limits of agreement were too large to be clinically useful. Conclusion: Based on these data, respiratory mechanics estimated from the pulse technique are too inaccurate to be clinically useful.

    Original languageEnglish
    Pages (from-to)130-134
    Number of pages5
    JournalCritical Care and Resuscitation
    Volume14
    Issue number2
    Publication statusPublished - 2012

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