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Tracking respiratory mechanics around natural breathing rates via variable ventilation
Measuring respiratory resistance and elastance as a function of time, tidal volume, respiratory rate, and positive end-expiratory pressure can guide mechanical ventilation. However, current measurement techniques are limited since they are assessed intermittently at non-physiological frequencies or...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174375/ https://www.ncbi.nlm.nih.gov/pubmed/32317734 http://dx.doi.org/10.1038/s41598-020-63663-8 |
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author | Bou Jawde, Samer Walkey, Allan J. Majumdar, Arnab O’Connor, George T. Smith, Bradford J. Bates, Jason H. T. Lutchen, Kenneth R. Suki, Béla |
author_facet | Bou Jawde, Samer Walkey, Allan J. Majumdar, Arnab O’Connor, George T. Smith, Bradford J. Bates, Jason H. T. Lutchen, Kenneth R. Suki, Béla |
author_sort | Bou Jawde, Samer |
collection | PubMed |
description | Measuring respiratory resistance and elastance as a function of time, tidal volume, respiratory rate, and positive end-expiratory pressure can guide mechanical ventilation. However, current measurement techniques are limited since they are assessed intermittently at non-physiological frequencies or involve specialized equipment. To this end, we introduce ZVV, a practical approach to continuously track resistance and elastance during Variable Ventilation (VV), in which frequency and tidal volume vary from breath-to-breath. ZVV segments airway pressure and flow recordings into individual breaths, calculates resistance and elastance for each breath, bins them according to frequency or tidal volume and plots the results against bin means. ZVV’s feasibility was assessed clinically in five human patients with acute lung injury, experimentally in five mice ventilated before and after lavage injury, and computationally using a viscoelastic respiratory model. ZVV provided continuous measurements in both settings, while the computational study revealed <2% estimation errors. Our findings support ZVV as a feasible technique to assess respiratory mechanics under physiological conditions. Additionally, in humans, ZVV detected a decrease in resistance and elastance with time by 12.8% and 6.2%, respectively, suggesting that VV can improve lung recruitment in some patients and can therefore potentially serve both as a dual diagnostic and therapeutic tool. |
format | Online Article Text |
id | pubmed-7174375 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-71743752020-04-24 Tracking respiratory mechanics around natural breathing rates via variable ventilation Bou Jawde, Samer Walkey, Allan J. Majumdar, Arnab O’Connor, George T. Smith, Bradford J. Bates, Jason H. T. Lutchen, Kenneth R. Suki, Béla Sci Rep Article Measuring respiratory resistance and elastance as a function of time, tidal volume, respiratory rate, and positive end-expiratory pressure can guide mechanical ventilation. However, current measurement techniques are limited since they are assessed intermittently at non-physiological frequencies or involve specialized equipment. To this end, we introduce ZVV, a practical approach to continuously track resistance and elastance during Variable Ventilation (VV), in which frequency and tidal volume vary from breath-to-breath. ZVV segments airway pressure and flow recordings into individual breaths, calculates resistance and elastance for each breath, bins them according to frequency or tidal volume and plots the results against bin means. ZVV’s feasibility was assessed clinically in five human patients with acute lung injury, experimentally in five mice ventilated before and after lavage injury, and computationally using a viscoelastic respiratory model. ZVV provided continuous measurements in both settings, while the computational study revealed <2% estimation errors. Our findings support ZVV as a feasible technique to assess respiratory mechanics under physiological conditions. Additionally, in humans, ZVV detected a decrease in resistance and elastance with time by 12.8% and 6.2%, respectively, suggesting that VV can improve lung recruitment in some patients and can therefore potentially serve both as a dual diagnostic and therapeutic tool. Nature Publishing Group UK 2020-04-21 /pmc/articles/PMC7174375/ /pubmed/32317734 http://dx.doi.org/10.1038/s41598-020-63663-8 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Bou Jawde, Samer Walkey, Allan J. Majumdar, Arnab O’Connor, George T. Smith, Bradford J. Bates, Jason H. T. Lutchen, Kenneth R. Suki, Béla Tracking respiratory mechanics around natural breathing rates via variable ventilation |
title | Tracking respiratory mechanics around natural breathing rates via variable ventilation |
title_full | Tracking respiratory mechanics around natural breathing rates via variable ventilation |
title_fullStr | Tracking respiratory mechanics around natural breathing rates via variable ventilation |
title_full_unstemmed | Tracking respiratory mechanics around natural breathing rates via variable ventilation |
title_short | Tracking respiratory mechanics around natural breathing rates via variable ventilation |
title_sort | tracking respiratory mechanics around natural breathing rates via variable ventilation |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174375/ https://www.ncbi.nlm.nih.gov/pubmed/32317734 http://dx.doi.org/10.1038/s41598-020-63663-8 |
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