Monitoring of Mechanical Ventilation

  • S. Benito


Spectacular progress has been made in the application of new technology in the designing of equipment for mechanical ventilation. This technology has made accurate measurements possible without altering the main function of the ventilator. These improvements have made the equipment not only better on ventilatory support but also infinitely safer. In recent years bioengineers have been studying the equipment we use (Hill and Dolan 1982; Cook and Webster 1982; Ward 1985). The incorporation of measurement systems in ventilators has presented a paradox in that we know more about the pulmonary functional state of a patient when connected to a ventilator than when breathing spontaneously. A simple parameter such as the minute volume is difficult to ascertain continuously in patients with acute respiratory failure who are not connected to a ventilator. Pulmonary compliance is inaccessible initially in such an acute patient in intensive care, but the calculation of both parameters becomes extremely simple once the patient is attached to a ventilator.


Mechanical Ventilation Tidal Volume Acute Respiratory Failure Pulmonary Compliance Inspiratory Muscle Strength 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Baron JF, Rieuf P, Herigault R, Lemaire F (1983) Contamination d’un circuit d’oxygène par de l’air comprimé. Ann Fr Anesth Reanim 2. 428–430PubMedCrossRefGoogle Scholar
  2. Bendixen HH, Egbert LD, Hedley-Whyte J, Laver MB, Pontoppidan H (1965) Respiratory care. Mosby S Louis, 72Google Scholar
  3. Blanch L, Fernandez R, Benito S, Mancebo J, Net A (1987) Effect of PEEP on the arterialend-tidal carbon dioxide gradient. Chest 92: 451–454PubMedCrossRefGoogle Scholar
  4. Bredbacka S, Kawachi S, Norlander O, Kirk B (1984) Gas exchange during ventilator treatment: a validation of a computerized technique and its comparison with the Douglas bag method. Acta Anaesthesiol Scand 28: 462–468PubMedCrossRefGoogle Scholar
  5. Canet J, Vinas J, Navajas D, Casan P, Sanchis J (1985) Variability of the breathing pattern in normals at rest. Bull Eur Physiopathol Respir 21: 27AGoogle Scholar
  6. Caviedes I, Benito S, Mancebo J, Net A (1986) The effect of intrinsic positive end-expiratory pressure on respiratory compliance. Crit Care Med 14: 947–949PubMedCrossRefGoogle Scholar
  7. Christopher K, Neff T, Bowmann J, Eberle D, Irvin C, Good J (1985) Demand and continuous flow intermittent mandatory ventilation systems. Chest 87: 625–630PubMedCrossRefGoogle Scholar
  8. Cook AM, Webster JG (1982) Therapeutic medical devices. Application and design. Prentice-Hall, Englewood CliffsGoogle Scholar
  9. Dairoli R, Perret C (1984) Mechanical controlled hypoventilation in status asthmaticus. Am Rev Respir Dis 129: 385–387Google Scholar
  10. Falke K, Pontoppidan H, Kumar A, Leith DE, Geffin B, Laver MB (1972) Ventilation with end-expiratory pressure in acute lung disease. J Clin Invest 51: 2315–2323PubMedCrossRefGoogle Scholar
  11. Fernandez R, Benito S, Sanchis J, Milic-Emili J, Net A (1988) Inspiratory effort and occlusion pressure in triggered mechanical ventilation. Intensive Care Med 14: 650–653PubMedGoogle Scholar
  12. Fletcher R (1985) Dead space, invasive and non-invasive. Br J Anaesth 57: 245–249PubMedCrossRefGoogle Scholar
  13. Fletcher R, Jonson B (1984) Dead space and the single breath test for carbon dioxide during anaesthesia and artificial ventilation. Br J Anaesth 56: 109–119PubMedCrossRefGoogle Scholar
  14. Goldenheim PD, Kazemi (1984) Cardiopulmonary monitoring of critically ill patients. N Engl Med 311: 717–720CrossRefGoogle Scholar
  15. Hill DW, Dolan AM (1982) Intensive care instrumentation. Academic, LondonGoogle Scholar
  16. Jonmarker C, Jansson L, Jonson B, Larsson A, Werner O (1985) Measurement of functional residual capacity by sulfur hexafluoride washout. Anesthesiology 63: 89–95PubMedCrossRefGoogle Scholar
  17. Jonson B, Nordstrom L, Olsson SG, Akerback D (1975) Monitoring of ventilation and lung mechanics during automatic ventilation. A new device. Bull Physiopathol Respir 11: 729–743Google Scholar
  18. Laaban JP, Lemaire F, Baron JF, Trunet P, Harf A, Bonnet JL, Teisseire B (1985) Influence of caloric intake on the respiratory mode during mandatory minute ventilation. Chest 87: 67–72PubMedCrossRefGoogle Scholar
  19. Lemaire F (1987) Monitorización respiratoria durante la ventilación mecânica. In: Net A, Benito S (eds) Ventilación mecânica. Doyma, Barcelona, p 115Google Scholar
  20. Mancebo J, Calaf N, Benito S (1985) Pulmonary compliance measurement in acute respiratory failure. Crit Care Med 13: 589–591PubMedCrossRefGoogle Scholar
  21. Mankikian B, Lemaire F, Benito S, Brun-Buisson C, Harf A, Maillot JP, Becker J (1982) A new device for measurement of pulmonary pressure-volume curves in patients on mechanical ventilation. Crit Care Med 11: 897–901CrossRefGoogle Scholar
  22. Marini JJ, Smith TC, Lamb V (1986) Estimation of inspiratory muscle strength in mechanically ventilated patients: the measurement of maximal inspiratory pressure. J Crit Care 1: 32–38CrossRefGoogle Scholar
  23. Matamis D, Lemaire F, Harf A, Brun-Buisson C, Ansquer JC, Atlan C (1984) Total respiratory pressure-volume curves in the adult respiratory distress syndrome. Chest 86: 58–66PubMedCrossRefGoogle Scholar
  24. Murray IP, Modell JH, Gallagher TJ, Banner MJ (1984) Titration of PEEP by the arterial minus end-tidal carbon dioxide gradient Chest 85: 100–104PubMedCrossRefGoogle Scholar
  25. Pepe PE, Marini JJ (1982) Occult positive end-expiratory pressure in mechanically ventilated patients with airflow obstruction. The auto-PEEP effect. Am Rev Respir Dis 126: 166–170PubMedGoogle Scholar
  26. Perrin F, Perrot D, Holzapfel L, Robert D (1983) Simultaneous variations of Pa CO2 and PA CO2 in assisted ventilation. Br J Anaesth 55: 525–530PubMedCrossRefGoogle Scholar
  27. Rossi A, Gothfried SB, Zocchi L, Higgs BD, Lennox S, Calverly PMA, Begin P, Grassino A, Milic-Emili J (1985) Measurement of static compliance of the total respiratory system in patients with acute respiratory failure during mechanical ventilation: the effect of intrinsic PEEP. Am Rev Respir Dis 131: 672–677PubMedGoogle Scholar
  28. Suter PM, Fairley HB, Isenberg MD (1971) Optimum end-expiratory airway pressure in patients with acute pulmonary failure. N Engl J Med 292: 284–289CrossRefGoogle Scholar
  29. Suter PM, Fairley HB, Isenberg MD (1978) Effect of tidal volume and positive end-expiratory pressure on compliance during mechanical ventilation. Chest 73: 158–162PubMedCrossRefGoogle Scholar
  30. Ward CS (1985) Anaesthetic equipment. Bailliere Tindall, LondonGoogle Scholar
  31. Younes MK, Remmers JE (1981) Control of tidal volume and respiratory frequency. In: Hornbein TF (ed) Regulation of Breathing. Dekker, New York, pp 621–671 (Lung biology in health and disease, vol 17 )Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • S. Benito

There are no affiliations available

Personalised recommendations