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Measurement of Lung Volumes and Gas Distribution during Mechanical Ventilation

  • J. C. Pompe
  • P. E. Huygen
  • H. A. Bruining
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine 1994 book series (YEARBOOK, volume 1994)

Abstract

Monitoring of lung volumes during mechanical ventilation (MV) is currently limited to tidal volume (TT), and end-expiratory lung volume (VEE). Measurement of other components of the total lung capacity is not feasible without full co-operation of the patient and hence is not suitable for routine measurement in an ICU setting. Although most ventilator adjustments are accurately based on clinical, radiological and blood gas assessments, many critically ill patients are likely to benefit from monitoring of lung volumes thereby allowing assessment of their progress and evaluation of treatment.

Keywords

Chronic Obstructive Pulmonary Disease Lung Volume Adult Respiratory Distress Syndrome Lung Lavage Methacholine Challenge 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Broseghini C, Brandolese R, Poggi R, et al (1988) Respiratory mechanics during the first day of mechanical ventilation in patients with pulmonary edema and chronic airway obstruction. Am Rev Respir Dis 138: 355–361PubMedGoogle Scholar
  2. 2.
    Wright PE, Bernard GR (1989) The role of airflow resistance in patients with the adult respiratory distress syndrome. Am Rev Respir Dis 139: 1169–1174PubMedGoogle Scholar
  3. 3.
    Eissa NT, Ranieri VM, Corbeil C, et al (1991) Analysis of behavior of the respiratory system in ARDS patients: Effect of flow, volume, and time. J Appl Physiol 70: 2719–2729PubMedCrossRefGoogle Scholar
  4. 4.
    Murray JF, Matthay MA, Luce JM, Flick MR (1988) An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis 138: 720–723PubMedGoogle Scholar
  5. 5.
    Petty TL (1988) ARDS: Refinement of concept and redefinition. Am Rev Respir Dis 138: 724PubMedGoogle Scholar
  6. 6.
    Gattinoni L, Pesenti A (1987) ARDS: The nonhomogeneous lung. Facts and hypothesis. Intensive Crit Care Digest 61: 1–3Google Scholar
  7. 7.
    Gottfried SB (1988) Dynamic hyperinflation, intrinsic PEEP and the mechanically ventilated patient. Intensive Crit Care Digest 5: 30–33Google Scholar
  8. 8.
    East TD (1993) Measurement of lung volume at the bedside. In: Kacmarek RM, Hess D, Stoller JK (eds) Monitoring in respiratory care, 1st edn. Mosby-Year Book Inc., St. Louis, pp 545–564Google Scholar
  9. 9.
    Hylkema BS, Barkmeiger-Degenhart P, Van der Mark TW, et al (1982) Measurement of functional residual capacity during mechanical ventilation for acute respiratory failure. Chest 81: 27–30PubMedCrossRefGoogle Scholar
  10. 10.
    Weaver LJ, Pierson DJ, Kellie R, et al (1981) A practical procedure for measuring functional residual capacity during mechanical ventilation with or without PEEP. Crit Care Med 9: 873–877PubMedCrossRefGoogle Scholar
  11. 11.
    Ibanez J, Raurich JM, Moris SG (1983) Measurement of functional residual capacity during mechanical ventilation. Comparison of a computerized open nitrogen washout method with a closed helium dilution method. Intensive Care Med 9: 91–93PubMedCrossRefGoogle Scholar
  12. 12.
    Suter PM, Schlobohm RM (1974) Determination of functional residual capacity during mechanical ventilation. Anesthesiology 41: 605–607PubMedCrossRefGoogle Scholar
  13. 13.
    Richardson P, Anderson M (1982) Automated nitrogen-washout methods for infants, evaluated using cats and a mechanical lung. J Appl Physiol 52: 1378–1382PubMedGoogle Scholar
  14. 14.
    Paloski WH, Newell JC, Gisser DG, et al (1981) A system to measure functional residual capacity in critically ill patients. Crit Care Med 9: 342–346PubMedCrossRefGoogle Scholar
  15. 15.
    Carlon GC, Miodownik S, Ray C, et al (1984) A computerized technique to measure functional residual capacity in patients on mechanical ventilation. Crit Care Med 12: 274CrossRefGoogle Scholar
  16. 16.
    East TD, Andriano KP, Pace NL (1987) Automated measurements of functional residual capacity by sulfur hexafluoride washout. J Clin Monit 3: 14–21PubMedCrossRefGoogle Scholar
  17. 17.
    East TD, Wortelboer PJM, van Ark E, et al (1990) Automated sulfur hexafluoride washout functional residual capacity measurement system for any mode of mechanical ventilation as well as spontaneous respiration. Crit Care Med 18: 84–91PubMedCrossRefGoogle Scholar
  18. 18.
    Jonmarker C, Jansson L, Jonson B, et al (1985) Measurement of functional residual capacity by sulfur hexafluoride washout. Anesthesiology 63: 89–95PubMedCrossRefGoogle Scholar
  19. 19.
    Larson A, Linnarsson D, Jonmarker C, et al (1987) Measurement of lung volume by sulfur hexafluoride washout during spontaneous and controlled ventilation: Further development of a method. Anesthesiology 67: 543–550CrossRefGoogle Scholar
  20. 20.
    Jonmarker C, Castor R, Drefeldt B, et al (1985) An analyzer for in-line measurement of expiratory sulfur hexafluoride concentration. Anesthesiology 63: 84–88PubMedCrossRefGoogle Scholar
  21. 21.
    Huygen PEM, Gültuna I, Ince C, et al (1993) A new ventilation inhomogeneity index from multiple breath indicator gas washout tests in mechanically ventilated patients. Crit Care Med 21: 1149–1158PubMedCrossRefGoogle Scholar
  22. 22.
    Gültuna I, Huygen PEM, Jabaaij C, et al (1992) A simple device to inject indicator gas for washout tests during mechanical ventilation. Intensive Care Med 18: 304–308PubMedCrossRefGoogle Scholar
  23. 23.
    Huygen PEM, Feenstra BWA, Holland WPJ, et al (1990) Design and validation of an indicator gas injector for multiple gas wash-out tests in mechanically ventilated patients. Crit Care Med 18: 754–759PubMedCrossRefGoogle Scholar
  24. 24.
    East TD, in’t Veen JC, Jonker TA, et al (1988) Computer controlled positive end-expiratory pressure titration for effective oxygenation without frequent blood gases. Crit Care Med 16: 252–257PubMedCrossRefGoogle Scholar
  25. 25.
    Huygen PEM, Feenstra BWA, Hoorn E, et al (1991) PDPS, a pulmonary data processing system for assessment of gas exchange properties by multiple gas washout. Comp Meth Prog Biomed 36: 223–235CrossRefGoogle Scholar
  26. 26.
    Haldane JS, Priestley JG (1905) The regulation of the lung ventilation. J Physiol 32: 225–266PubMedGoogle Scholar
  27. 27.
    Becklake MR (1952) A new index of the intrapulmonary mixture of inspired air. Thorax 7: 111–116PubMedCrossRefGoogle Scholar
  28. 28.
    Saidel GM, Salmon RB, Chester EH (1975) Moment analysis of pulmonary washout. J Appl Physiol 38: 328–334PubMedGoogle Scholar
  29. 29.
    Pompe JC, Gültuna I, Huygen PEM, et al (1992) End-expiratory lung volume and ventilation inhomogeneity during induced bronchoconstriction in pigs. Intensive Care Med 18: S219 (Abst)Google Scholar
  30. 30.
    Kesecioglu J, Gültuna I, Pompe JC, et al (1992) Assessment of ventilation inhomogeneity and gas exchange with volume controlled ventilation and pressure controlled inverse ratio ventilation on pigs with surfactant depleted lungs. Intensive Care Med 18: S222 (Abst)Google Scholar
  31. 31.
    Kesecioglu J, Pompe JC, Gültuna I, et al (1992) Reduction of ventilation inhomogeneity with ketanserin in pigs with ARDS. Intensive Care Med 18: S172 (Abst)CrossRefGoogle Scholar
  32. 32.
    Lachmann B, Robertson B, Vogel J (1980) In vivo lung lavage as an experimental model of the respiratory distress syndrome. Acta Anaesth Scand 24: 231–236PubMedCrossRefGoogle Scholar
  33. 33.
    Gültuna I, Huygen PEM, Strijdhorst H, et al (1990) Clinical applications of an indicator washout test during artificial ventilation. Intensive Care Med 16: S165 (Abst)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • J. C. Pompe
  • P. E. Huygen
  • H. A. Bruining

There are no affiliations available

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