Validation and clinical application of a first order step response equation for nitrogen clearance during FRC measurement.

Objective: To derive a difference equation based on mass conservation and on alveolar tidal volumes for the calculation of Functional Residual Capacity. Derive an equation for the FRC from the difference equation. Furthermore, to derive and validate a step response equation as a solution of the diff...

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Publicado en:Journal of Clinical Monitoring & Computing Vol. 22; no. 1; pp. 1 - 10
Autores principales: Choncholas G, Sondergaard S, Heinonen E, Choncholas, Gary, Sondergaard, Soren, Heinonen, Erkki
Formato: research Journal Article
Publicado: Springer Nature Jan2008
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Journal of Clinical Monitoring & Computing
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      dt: Jan2008
      vid: 22
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      pub: Springer Nature
      place: New York, New York
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        NLM18004668
        2009821577
        10.1007/s10877-007-9101-0
        NLM18004668
        105747577
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        atl: Validation and clinical application of a first order step response equation for nitrogen clearance during FRC measurement.
      aug:
        au:
          Choncholas G
          Sondergaard S
          Heinonen E
          Choncholas, Gary
          Sondergaard, Soren
          Heinonen, Erkki
        affil: Department of Research & Development, GE Healthcare, Madison, WI, USA
      sug:
        subj:
          Functional Residual Capacity Physiology
          Models, Biological
          Nitrogen Metabolism
          Signal Processing, Computer Assisted
          Adult
          Aged
          Breath Tests
          Female
          Male
          Middle Age
          Monitoring, Physiologic Methods
          Pulmonary Alveoli Metabolism
          Regression
          Tidal Volume Physiology
          Respiration, Artificial
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objective: To derive a difference equation based on mass conservation and on alveolar tidal volumes for the calculation of Functional Residual Capacity. Derive an equation for the FRC from the difference equation. Furthermore, to derive and validate a step response equation as a solution of the difference equation within the framework of digital signal processing where the FRC is known a priori.Methods: A difference equation for the calculation of Functional Residual Capacity is derived and solved as step response of a first order system. The step response equation calculates endtidal fractions of nitrogen during multiple breath nitrogen clearance. The step response equation contains the eigenvalue defined as the ratio of FRC to the sum of FRC and alveolar tidal ventilation. Agreement of calculated nitrogen fractions with measured fractions is demonstrated with data from a metabolic lung model, measurements from patients in positive pressure ventilation and volunteers breathing spontaneously. Examples of eigenvalue are given and compared between diseased and healthy lungs and between ventilatory settings.Results: Comparison of calculated and measured fractions of endtidal nitrogen demonstrates a high degree of agreement in terms of regression and bias and limits of agreement (precision) in Bland & Altman analysis. Examples illustrate the use of the eigenvalue as a possible discriminator between disease states.Conclusion: The first order step response equation reliably calculates endtidal fractions of nitrogen during washout based on a Functional Residual Capacity. The eigenvalue may be a clinically valuable index alone or in conjunction with other indices in the analysis of respiratory states and may aid in the setting of the ventilator.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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