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volumetric capnography

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https://www.readbyqxmd.com/read/28611227/lung-injury-etiology-and-other-factors-influencing-the-relationship-between-dead-space-fraction-and-mortality-in-ards
#1
Richard H Kallet, Hanjing Zhuo, Kelly Ho, Michael S Lipnick, Antonio Gomez, Michael A Matthay
BACKGROUND: In ARDS, elevated pulmonary dead-space fraction (VD/VT) is a particularly strong indicator of mortality risk. Whether the magnitude of VD/VT is modified by the underlying etiology of ARDS and whether this influences the strength of its association with mortality remains unknown. We sought to elucidate the impact of ARDS etiology on VD/VT and also to determine whether ARDS severity, as classified by the Berlin definition, has correspondence with changes in VD/VT. METHODS: This single-center, retrospective, observational study (2010-2016) measured VD/VT in 685 subjects with ARDS as part of clinical management with lung-protective ventilation...
June 13, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28584436/titration-of-ideal-positive-end-expiratory-pressure-in-acute-respiratory-distress-syndrome-comparison-between-lower-inflection-point-and-esophageal-pressure-method-using-volumetric-capnography
#2
Nandakishore Baikunje, Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy Thurai Prasad, Ritesh Agarwal
The tenets of mechanical ventilation in acute respiratory distress syndrome (ARDS) include the utilization of low tidal volume and optimal application of positive end-expiratory pressure (PEEP). Optimal PEEP in ARDS is characterized by reduction in alveolar dead space along with improvement in the lung compliance and resultant betterment in oxygenation. There are various methods of setting PEEP in ARDS. Herein, we report a patient of ARDS, wherein we employed measurement of dead space using volumetric capnography to compare two different PEEP strategies, namely, the lower inflection point and transpulmonary pressure monitoring...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28493943/open-lung-approach-versus-standard-protective-strategies-effects-on-driving-pressure-and-ventilatory-efficiency-during-anesthesia-a-pilot-randomized-controlled-trial
#3
Carlos Ferrando, Fernando Suarez-Sipmann, Gerardo Tusman, Irene León, Esther Romero, Estefania Gracia, Ana Mugarra, Blanca Arocas, Natividad Pozo, Marina Soro, Francisco J Belda
BACKGROUND: Low tidal volume (VT) during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM) can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia...
2017: PloS One
https://www.readbyqxmd.com/read/28432861/spirometry-and-volumetric-capnography-in-lung-function-assessment-of-obese-and-normal-weight-individuals-without-asthma
#4
Mariana S Ferreira, Roberto T Mendes, Fernando A L Marson, Mariana P Zambon, Maria A R G M Antonio, Ilma A Paschoal, Adyléia A D C Toro, Silvana D Severino, Maria A G O Ribeiro, José D Ribeiro
OBJECTIVE: To analyze and compare lung function of obese and healthy, normal-weight children and adolescents, without asthma, through spirometry and volumetric capnography. METHODS: Cross-sectional study including 77 subjects (38 obese) aged 5-17 years. All subjects underwent spirometry and volumetric capnography. The evaluations were repeated in obese subjects after the use of a bronchodilator. RESULTS: At the spirometry assessment, obese individuals, when compared with the control group, showed lower values of forced expiratory volume in the first second by forced vital capacity (FEV1/FVC) and expiratory flows at 75% and between 25 and 75% of the FVC (p<0...
April 19, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28413621/recent-advances-in-pediatric-ventilatory-assistance
#5
REVIEW
Nicolas Nardi, Guillaume Mortamet, Laurence Ducharme-Crevier, Guillaume Emeriaud, Philippe Jouvet
In this review on respiratory assistance, we aim to discuss the following recent advances: the optimization and customization of mechanical ventilation, the use of high-frequency oscillatory ventilation, and the role of noninvasive ventilation. The prevention of ventilator-induced lung injury and diaphragmatic dysfunction is now a key aspect in the management of mechanical ventilation, since these complications may lead to higher mortality and prolonged length of stay in intensive care units. Different physiological measurements, such as esophageal pressure, electrical activity of the diaphragm, and volumetric capnography, may be useful objective tools to help guide ventilator assistance...
2017: F1000Research
https://www.readbyqxmd.com/read/28223465/assessment-of-bohr-and-enghoff-dead-space-equations-in-mechanically-ventilated-children
#6
Pierre Bourgoin, Florent Baudin, David Brossier, Guillaume Emeriaud, Marc Wysocki, Philippe Jouvet
BACKGROUND: Recent findings suggest that using alveolar PCO2 (PACO2 ) estimated by volumetric capnography in the Bohr equation instead of PaCO2 (Enghoff modification) could be appropriate for the calculation of physiological dead space to tidal volume ratio (VD/VT Bohr and VD/VT Enghoff, respectively). We aimed to describe the relationship between these 2 measurements in mechanically ventilated children and their significance in cases of ARDS. METHODS: From June 2013 to December 2013, mechanically ventilated children with various respiratory conditions were included in this study...
April 2017: Respiratory Care
https://www.readbyqxmd.com/read/28003557/comparing-the-effects-of-two-different-levels-of-hyperoxygenation-on-gas-exchange-during-open-endotracheal-suctioning-a-randomized-crossover-study
#7
Jacqueline Rodrigues de Freitas Vianna, Valéria Amorim Pires Di Lorenzo, Miléa Mara Lourenço da Silva Simões, Maurício Jamami
BACKGROUND: Endotracheal suctioning is required for mechanically ventilated patients to maintain a patent airway. Studies show that open endotracheal suctioning affects respiratory mechanics and gas exchange. The aim of this study was to compare the effectiveness of hyperoxygenation with FIO2 + 0.20 above baseline and hyperoxygenation with FIO2 1.0 in preventing hypoxemia, and to determine the impact of open endotracheal suctioning on the pulmonary ventilation of critical subjects receiving mechanical ventilatory support...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27991422/volumetric-capnography-in-the-exclusion-of-pulmonary-embolism-at-the-emergency-department-a-pilot-study
#8
Timon M Fabius, Michiel M Eijsvogel, Ivo van der Lee, Marjolein G J Brusse-Keizer, Frans H de Jongh
The analysis of the [Formula: see text] in expired air as a function of the exhaled volume (volumetric capnography) might result in a more specific exclusion tool for pulmonary embolism (PE) in addition to the Wells-score and D-dimer. A novel combination of volumetric capnography parameters ([Formula: see text]) should be decreased in PE and could possibly be used to decrease the number of requested computed tomography pulmonary angiograms (CTPA). Volumetric capnography measurements were performed on consecutive patients seen in the emergency department for which, due to suspected PE (due to increased D-dimer level or Wells-score), a CTPA was ordered...
December 17, 2016: Journal of Breath Research
https://www.readbyqxmd.com/read/27856714/nasal-high-flow-reduces-dead-space
#9
Winfried Möller, Sheng Feng, Ulrike Domanski, Karl-Josef Franke, Gülnaz Celik, Peter Bartenstein, Sven Becker, Gabriele Meyer, Otmar Schmid, Oliver Eickelberg, Stanislav Tatkov, Georg Nilius
Recent studies show that nasal high flow (NHF) therapy can support ventilation in patients with acute or chronic respiratory disorders. Clearance of dead space has been suggested as being the key mechanism of respiratory support with NHF therapy. The hypothesis of this study was that NHF in a dose-dependent manner can clear dead space of the upper airways from expired air and decrease rebreathing. The randomized crossover study involved 10 volunteers using scintigraphy with (81m)Krypton ((81m)Kr) gas during a breath-holding maneuver with closed mouth and in 3 nasally breathing tracheotomized patients by volumetric capnography and oximetry through sampling CO2 and O2 in the trachea and measuring the inspired volume with inductance plethysmography following NHF rates of 15, 30, and 45 l/min...
January 1, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27688911/can-transcutaneous-co2-tension-be-used-to-calculate-ventilatory-dead-space-a-pilot-study
#10
Pradeep H Lakshminarayana, Adiba A Geeti, Umer M Darr, David A Kaufman
Dead space fraction (V d/V t) measurement performed using volumetric capnography requires arterial blood gas (ABG) sampling to estimate the partial pressure of carbon dioxide (PaCO2). In recent years, transcutaneous capnography (PtcCO2) has emerged as a noninvasive method of estimating PaCO2. We hypothesized that PtcCO2 can be used as a substitute for PaCO2 in the calculation of V d/V t. In this prospective pilot comparison study, 30 consecutive postcardiac surgery mechanically ventilated patients had V d/V t calculated separately using volumetric capnography by substituting PtcCO2 for PaCO2...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27632057/noninvasive-estimation-of-arterial-co2-from-end-tidal-co2-in-mechanically-ventilated-children-the-graedient-pilot-study
#11
Florent Baudin, Pierre Bourgoin, David Brossier, Sandrine Essouri, Guillaume Emeriaud, Marc Wysocki, Philippe Jouvet
OBJECTIVES: The aim of our pilot study was to develop a model to better predict Paco2 in mechanically ventilated children using noninvasive parameters including volumetric capnography. DESIGN: Prospective clinical pilot study. SETTING: Level III PICU. PATIENTS: Sixty-five mechanically ventilated children. INTERVENTIONS: None. MATERIALS AND METHODS: We conducted a prospective clinical pilot study that included all children admitted to the PICU (< 18 yr; weight, > 3 kg; mechanically ventilated, > 6 hr; with an arterial line)...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27576441/current-methodological-and-technical-limitations-of-time-and-volumetric-capnography-in-newborns
#12
REVIEW
Gerd Schmalisch
Although capnography is a standard tool in mechanically ventilated adult and pediatric patients, it has physiological and technical limitations in neonates. Gas exchange differs between small and adult lungs due to the greater impact of small airways on gas exchange, the higher impact of the apparatus dead space on measurements due to lower tidal volume and the occurrence of air leaks in intubated patients. The high respiratory rate and low tidal volume in newborns, especially those with stiff lungs, require main-stream sensors with fast response times and minimal dead-space or low suction flow when using side-stream measurements...
August 30, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/27334879/volumetric-capnography-lessons-from-the-past-and-current-clinical-applications
#13
REVIEW
Sara Verscheure, Paul B Massion, Franck Verschuren, Pierre Damas, Sheldon Magder
Dead space is an important component of ventilation-perfusion abnormalities. Measurement of dead space has diagnostic, prognostic and therapeutic applications. In the intensive care unit (ICU) dead space measurement can be used to guide therapy for patients with acute respiratory distress syndrome (ARDS); in the emergency department it can guide thrombolytic therapy for pulmonary embolism; in peri-operative patients it can indicate the success of recruitment maneuvers. A newly available technique called volumetric capnography (Vcap) allows measurement of physiological and alveolar dead space on a regular basis at the bedside...
June 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27321293/comparison-of-the-pulmonary-dead-space-fraction-derived-from-ventilator-volumetric-capnography-and-a-validated-equation-in-the-survival-prediction-of-patients-with-acute-respiratory-distress-syndrome
#14
COMPARATIVE STUDY
Yu-Jiao Zhang, Xin-Jing Gao, Zhi-Bo Li, Zhi-Yong Wang, Quan-Sheng Feng, Cheng-Fen Yin, Xing Lu, Lei Xu
PURPOSE: This prospective observational study aims to evaluate the accuracy of dead-space fraction derived from the ventilator volumetric capnography (volumetric CO₂) or a prediction equation to predict the survival of mechanically ventilated patients with acute respiratory distress syndrome (ARDS). METHODS: Consecutive VD/VT measurements were obtained based upon a prediction equation validated by Frankenfield et al for dead-space ventilation fraction: VD/VT = 0...
June 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27317710/capnogram-slope-and-ventilation-dead-space-parameters-comparison-of-mainstream-and-sidestream-techniques
#15
A L Balogh, F Petak, G H Fodor, J Tolnai, Z Csorba, B Babik
BACKGROUND: Capnography may provide useful non-invasive bedside information concerning heterogeneity in lung ventilation, ventilation-perfusion mismatching and metabolic status. Although the capnogram may be recorded by mainstream and sidestream techniques, the capnogram indices furnished by these approaches have not previously been compared systematically. METHODS: Simultaneous mainstream and sidestream time and volumetric capnography was performed in anaesthetized, mechanically ventilated patients undergoing elective heart surgery...
July 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27199318/detection-of-optimal-peep-for-equal-distribution-of-tidal-volume-by-volumetric-capnography-and-electrical-impedance-tomography-during-decreasing-levels-of-peep-in-post-cardiac-surgery-patients
#16
P Blankman, A Shono, B J M Hermans, T Wesselius, D Hasan, D Gommers
BACKGROUND: Homogeneous ventilation is important for prevention of ventilator-induced lung injury. Electrical impedance tomography (EIT) has been used to identify optimal PEEP by detection of homogenous ventilation in non-dependent and dependent lung regions. We aimed to compare the ability of volumetric capnography and EIT in detecting homogenous ventilation between these lung regions. METHODS: Fifteen mechanically-ventilated patients after cardiac surgery were studied...
June 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27145818/assessment-of-dead-space-ventilation-in-patients-with-acute-respiratory-distress-syndrome-a-prospective-observational-study
#17
Jonne Doorduin, Joeke L Nollet, Manon P A J Vugts, Lisanne H Roesthuis, Ferdi Akankan, Johannes G van der Hoeven, Hieronymus W H van Hees, Leo M A Heunks
BACKGROUND: Physiological dead space (VD/VT) represents the fraction of ventilation not participating in gas exchange. In patients with acute respiratory distress syndrome (ARDS), VD/VT has prognostic value and can be used to guide ventilator settings. However, VD/VT is rarely calculated in clinical practice, because its measurement is perceived as challenging. Recently, a novel technique to calculate partial pressure of carbon dioxide in alveolar air (PACO2) using volumetric capnography (VCap) was validated...
May 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27042039/copd-phenotypes-on-computed-tomography-and-its-correlation-with-selected-lung-function-variables-in-severe-patients
#18
Silvia Maria Doria da Silva, Ilma Aparecida Paschoal, Eduardo Mello De Capitani, Marcos Mello Moreira, Luciana Campanatti Palhares, Mônica Corso Pereira
BACKGROUND: Computed tomography (CT) phenotypic characterization helps in understanding the clinical diversity of chronic obstructive pulmonary disease (COPD) patients, but its clinical relevance and its relationship with functional features are not clarified. Volumetric capnography (VC) uses the principle of gas washout and analyzes the pattern of CO2 elimination as a function of expired volume. The main variables analyzed were end-tidal concentration of carbon dioxide (ETCO2), Slope of phase 2 (Slp2), and Slope of phase 3 (Slp3) of capnogram, the curve which represents the total amount of CO2 eliminated by the lungs during each breath...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/26928760/capnographic-parameters-in-ventilated-patients-correspondence-with-airway-and-lung-tissue-mechanics
#19
Zsofia Csorba, Ferenc Petak, Kitti Nevery, Jozsef Tolnai, Adam L Balogh, Ferenc Rarosi, Gergely H Fodor, Barna Babik
BACKGROUND: Although the mechanical status of the lungs affects the shape of the capnogram, the relations between the capnographic parameters and those reflecting the airway and lung tissue mechanics have not been established in mechanically ventilated patients. We, therefore, set out to characterize how the mechanical properties of the airways and lung tissues modify the indices obtained from the different phases of the time and volumetric capnograms and how the lung mechanical changes are reflected in the altered capnographic parameters after a cardiopulmonary bypass (CPB)...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26828240/increased-volume-of-conducting-airways-in-idiopathic-pulmonary-fibrosis-is-independent-of-disease-severity-a-volumetric-capnography-study
#20
Laurent Plantier, Marie-Pierre Debray, Candice Estellat, Martin Flamant, Carine Roy, Catherine Bancal, Raphaël Borie, Dominique Israël-Biet, Hervé Mal, Bruno Crestani, Christophe Delclaux
Bronchiectasis, bronchiolectasis, and bronchiolisation of alveolar regions are salient features of idiopathic pulmonary fibrosis (IPF). We asked whether IPF was associated with physiological changes consistent with increases in the volume of conducting airways, and whether airway volume was related to the severity of lung fibrosis. Patients with IPF (N  =  57, vital capacity-VC: 73  ±  20%), patients with non-IPF interstitial lung disease (non-IPF ILD, N  =  24, VC  =  78  ±  18%) and controls without lung disease (N  =  51, VC  =  112  ±  21%) underwent volumetric capnography for the determination of conducting airway volume using Fletcher's equal area method, reported to predicted total lung capacity to control for the effect of lung size (VDaw/TLCp, mL/L)...
February 1, 2016: Journal of Breath Research
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