You searched for:"Juliana Arcanjo Lino"
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Original Article
Influences of assisted breathing and mechanical ventilator settings on tidal volume and alveolar pressures in acute respiratory distress syndrome: a bench study
Rev Bras Ter Intensiva. 2021;33(4):572-582
Abstract
Original ArticleInfluences of assisted breathing and mechanical ventilator settings on tidal volume and alveolar pressures in acute respiratory distress syndrome: a bench study
Rev Bras Ter Intensiva. 2021;33(4):572-582
DOI 10.5935/0103-507X.20210084
Views0ABSTRACT
Objective:
To evaluate the influences of respiratory muscle efforts and respiratory rate setting in the ventilator on tidal volume and alveolar distending pressures at end inspiration and expiration in volume-controlled ventilation and pressure-controlled ventilation modes in acute respiratory distress syndrome.
Methods:
An active test lung (ASL 5000™) connected to five intensive care unit ventilators was used in a model of acute respiratory distress syndrome. Respiratory muscle efforts (muscle pressure) were configured in three different ways: no effort (muscle pressure: 0cmH2O); inspiratory efforts only (muscle pressure:-5cmH2O, neural inspiratory time of 0.6s); and both inspiratory and expiratory muscle efforts (muscle pressure:-5/+5cmH2O). Volume-controlled and pressure-controlled ventilation modes were set to deliver a target tidal volume of 420mL and positive end-expiratory pressure of 10cmH2O. The tidal volume delivered to the lungs, alveolar pressures at the end of inspiration, and alveolar pressures at end expiration were evaluated.
Results:
When triggered by the simulated patient, the median tidal volume was 27mL lower than the set tidal volume (range-63 to +79mL), and there was variation in alveolar pressures with a median of 25.4cmH2O (range 20.5 to 30cmH2O). In the simulated scenarios with both spontaneous inspiratory and expiratory muscle efforts and with a mandatory respiratory rate lower than the simulated patient’s efforts, the median tidal volume was higher than controlled breathing.
Conclusion:
Adjusting respiratory muscle effort and pulmonary ventilator respiratory rate to a value above the patient’s respiratory rate in assisted/controlled modes generated large variations in tidal volume and pulmonary pressures, while the controlled mode showed no variations in these outcomes.
Keywords:artificialIntermittent positive-pressure breathingRespirationRespiratory distress syndromeVentilator-induced lung injurySee more -
Original Articles
Variations in the measurement of weaning parameters of mechanical ventilation in Fortaleza hospitals
Rev Bras Ter Intensiva. 2008;20(2):149-153
Abstract
Original ArticlesVariations in the measurement of weaning parameters of mechanical ventilation in Fortaleza hospitals
Rev Bras Ter Intensiva. 2008;20(2):149-153
DOI 10.1590/S0103-507X2008000200006
Views0See moreBACKGROUND AND OBJECTIVES: The number of patients requiring prolonged time on mechanical ventilation is increasing considerably in the intensive care unit (ICU). The objective of this study was to characterize the variability of methods and criteria used by physiotherapists to obtain weaning parameters in hospitals of Fortaleza. METHODS: After approval by the UNIFOR Ethics Committee, survey questionnaires were distributed among physiotherapists working in the ICU of three public and three private hospitals. Forty-four physiotherapists answered thirty-two multiple choice questions anonymously. RESULTS: The main results concerned parameters commonly evaluated by physiotherapists. A significant difference between hospitals was found regarding the rapid shallow breathing index and maximum inspiratory pressure, which are more often used in private hospitals, with a percentage of 100% and 89.5%, respectively. Concerning the ventilatory mode for obtaining the weaning parameters for mechanical ventilation; the T-tube was the most used, not only in the public (56%) but also in the private hospitals (57.9%). CONCLUSIONS: Variability in the methods and criteria used to obtain weaning parameters by the physiotherapists was found in public and private hospitals in Fortaleza. Results from this survey stress the need to develop new scientific studies to standardize the techniques used for weaning.
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness Extracorporeal membrane oxygenation Infant, newborn Intensive care Intensive care units Intensive care units, pediatric mechanical ventilation Mortality Physical therapy modalities Prognosis Respiration, artificial Respiratory insufficiency risk factors SARS-CoV-2 Sepsis