End-expiratory lung volume and ventilation distribution with different continuous positive airway pressure systems in volunteers

被引:13
|
作者
Andersson, B. [1 ]
Lundin, S. [1 ]
Lindgren, S. [1 ]
Stenqvist, O. [1 ]
Herges, H. Odenstedt [1 ]
机构
[1] Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Anesthesiol & Intens Care Med, Gothenburg, Sweden
关键词
ACUTE RESPIRATORY-FAILURE; ELECTRICAL-IMPEDANCE TOMOGRAPHY; RANDOMIZED CONTROLLED-TRIAL; WORK; RECRUITMENT;
D O I
10.1111/j.1399-6576.2010.02337.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background Continuous positive airway pressure (CPAP) has been shown to improve oxygenation and a number of different CPAP systems are available. The aim of this study was to assess lung volume and ventilation distribution using three different CPAP techniques. Methods A high-flow CPAP system (HF-CPAP), an ejector-driven system (E-CPAP) and CPAP using a Servo 300 ventilator (V-CPAP) were randomly applied at 0, 5 and 10 cmH(2)O in 14 volunteers. End-expiratory lung volume (EELV) was measured by N(2) dilution at baseline; changes in EELV and tidal volume distribution were assessed by electric impedance tomography. Results Higher end-expiratory and mean airway pressures were found using the E-CPAP vs. the HF-CPAP and the V-CPAP system (P < 0.01). EELV increased markedly from baseline, 0 cmH(2)O, with increased CPAP levels: 1110 +/- 380, 1620 +/- 520 and 1130 +/- 350 ml for HF-, E- and V-CPAP, respectively, at 10 cmH(2)O. A larger fraction of the increase in EELV occurred for all systems in ventral compared with dorsal regions (P < 0.01). In contrast, tidal ventilation was increasingly directed toward dorsal regions with increasing CPAP levels (P < 0.01). The increase in EELV as well as the tidal volume redistribution were more pronounced with the E-CPAP system as compared with both the HF-CPAP and the V-CPAP systems (P < 0.05) at 10 cmH(2)O. Conclusion EELV increased more in ventral regions with increasing CPAP levels, independent of systems, leading to a redistribution of tidal ventilation toward dorsal regions. Different CPAP systems resulted in different airway pressure profiles, which may result in different lung volume expansion and tidal volume distribution.
引用
收藏
页码:157 / 164
页数:8
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