Effect of prolongation of expiratory time on dynamic hyperinflation in mechanically ventilated patients with severe asthma

Critical Care Medicine
James W LeathermanRobert S Shapiro

Abstract

To assess the effect of a decrease in respiratory rate on dynamic hyperinflation, as determined by changes in plateau airway pressure, in patients with status asthmaticus whose baseline minute ventilation approximated 10 L/min. Observational descriptive study. Medical intensive care unit. Twelve patients with severe asthma mechanically ventilated in the assist control mode with a tidal volume of 613 +/- 100 mL and an inspiratory flow rate of 79 +/- 4 L/min. A decrease in respiratory rate from 18 to 12 and 6 breaths/min. Plateau airway pressure decreased by approximately 2 cm H2O (25.4 +/- 2.8 vs. 23.3 +/- 2.6 cm H2O, p <.01) when respiratory rate was decreased from 18 to 12 breaths/min (increase in expiratory time 1.7 secs) and by a similar amount (23.3 +/- 2.6 vs. 21.3 +/- 2.9 cm H2O, p <.01) when respiratory rate was decreased from 12 to 6 breaths/min (increase in expiratory time 5 secs). Peak airway pressure was similar at the three respiratory rates (66.8 +/- 8.7 vs. 66.4 +/- 9.5 vs. 67.8 +/- 11.1 cm H2O at 18, 12, and 6 breaths/min, respectively). End-expiratory flow rates (n = 7) were 61.4 +/- 12.6, 38.6 +/- 4.5, and 23.1 +/- 5.8 mL/sec at respiratory rates of 18, 12, and 6 breaths/min, respectively. Prolongation of expir...Continue Reading

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Citations

Mar 23, 2006·Intensive Care Medicine·Mauro OddoClaude Perret
Sep 23, 2008·Intensive Care Medicine·Sarah M KeslerJames W Leatherman
Jun 28, 2011·American Journal of Respiratory and Critical Care Medicine·John J Marini
Dec 17, 2005·Critical Care : the Official Journal of the Critical Care Forum·David R Stather, Thomas E Stewart
Sep 17, 2013·PloS One·Amir H ShiraziAli R Mani
Nov 11, 2009·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Rick HodderR Andrew McIvor
Nov 17, 2009·Drugs·Spyros A PapirisIraklis Tsangaris
Feb 14, 2013·Journal of the American Veterinary Medical Association·Bianca BoudreauKurt J Williams
Jun 3, 2015·Chest·James Leatherman
Jun 13, 2006·AACN Advanced Critical Care·Suzanne M Burns
Mar 30, 2013·Critical Care Clinics·James Schneider, Todd Sweberg
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Mar 16, 2016·Thorax·A Craig DavidsonUNKNOWN BTS Standards of Care Committee Member, British Thoracic Society/Intensive Care Society Acute Hypercapnic Respiratory Failur
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Jun 16, 2021·Notfall & Rettungsmedizin·Carsten LottJasmeet Soar

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