Parameters for Simulation of Adult Subjects During Mechanical Ventilation.
BACKGROUND: Simulation studies are often used to examine ventilator performance. However, there are no standards for selecting simulation parameters. This study collected data in passively-ventilated adult human subjects and summarized the results as a set of parameters that can be used for simulati...
| Publicado en: | Respiratory Care Vol. 63; no. 2; pp. 158 - 169 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Feb2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=127544995&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 127544995 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Feb2018 vid: 63 iid: 2 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 127544995 127544995 127544995 10.4187/respcare.05775 127544995 ppf: 158 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Parameters for Simulation of Adult Subjects During Mechanical Ventilation. aug: au: Arnal, Jean-Michel Garnero, Aude Saoli, Mathieu Chatburn, Robert L. affil: Service de Réanimation Polyvalente, Hôpital Sainte Musse, Toulon, France sug: subj: Respiration, Artificial Patient Simulation Human Adult Intensive Care Units Respiratory Distress Syndrome, Acute Pulmonary Disease, Chronic Obstructive Airway Resistance Prospective Studies Nonexperimental Studies Comparative Studies Kruskal-Wallis Test Analysis of Variance Data Analysis Software Adult: 19-44 years ab: BACKGROUND: Simulation studies are often used to examine ventilator performance. However, there are no standards for selecting simulation parameters. This study collected data in passively-ventilated adult human subjects and summarized the results as a set of parameters that can be used for simulation studies of intubated, passive, adult subjects with normal lungs, COPD, or ARDS. METHODS: Consecutive adult patients admitted to the ICU were included if they were deeply sedated and mechanically ventilated for <48 h without any spontaneous breathing activity. Subjects were classified as having normal lungs, COPD, or ARDS. Respiratory mechanics variables were collected once per subject. Static compliance was calculated as the ratio between tidal volume and driving pressure. Inspiratory resistance was measured by the least-squares fitting method. The expiratory time constant was estimated by the tidal volume/flow ratio. RESULTS: Of the 359 subjects included, 138 were classified as having normal lungs, 181 as ARDS, and 40 as COPD. Median (interquartile range) static compliance was significantly lower in ARDS subjects as compared with normal lung and COPD subjects (39 [32-50] mL/cm H2O vs 54 [44-64] and 59 [43-75] mL/cm H2O, respectively, P < .001). Inspiratory resistance was significantly higher in COPD subjects as compared with normal lung and ARDS subjects (22 [16-33] cm H2O/L/s vs 13 [10-15] and 12 [9-14] cm H2O/L/s, respectively, P < .001). The expiratory time constant was significantly different for each lung condition (0.60 [0.51-0.71], 1.07 [0.68-2.14], and 0.46 [0.40-0.55] s for normal lung, COPD, and ARDS subjects, respectively, P < .001). In the subgroup of subjects with ARDS, there were no significant differences in respiratory mechanics variables among mild, moderate, and severe ARDS. CONCLUSIONS: This study provides educators, researchers, and manufacturers with a standard set of practical parameters for simulating the respiratory system's mechanical properties in passive conditions. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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