Elastic work of breathing during continuous positive airway pressure in intubated patients with chronic obstructive pulmonary disease (theoretical analysis and experimental validation)

Acta Anaesthesiologica Scandinavica
J G AertsJ M Bogaard

Abstract

Continuous positive airway pressure (CPAP) is known to decrease inspiratory work of breathing in patients with chronic obstructive pulmonary disease (COPD). This effect is primarily attributed to a reduction in inspiratory elastic work of breathing (Wi,el) related to a decrease in intrinsic positive end-expiratory pressure (PEEP). The aim of this study is to design a model for computation of Wi,el on the basis of respiratory mechanics in patients with COPD, at various intrinsic PEEP- and CPAP-levels. The model was used to estimate the optimal CPAP-level with respect to the intrinsic PEEP-level in terms of reduction of Wi,el. Calculations of the decrease in Wi,el due to CPAP obtained with the model were compared to changes in Wi,el and total work of breathing (Wi,tot) determined from respiratory measurements in patients with COPD. Model calculations revealed that Wi,el was minimal whenever a CPAP-level equal to the intrinsic PEEP-level was applied. When a CPAP-level exceeding the intrinsic PEEP-level was applied, the reduction in Wi,el was less. Comparing these results to the respiratory measurements, a similar pattern in reduction of Wi,el and Wi,tot was established, although absolute values of the differences were smaller in t...Continue Reading

References

Feb 1, 1979·Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology·H J ColebatchN Nikov
Sep 1, 1989·Chest·M J Tobin, R F Lodato
Jan 1, 1986·Respiration; International Review of Thoracic Diseases·J M BogaardA Versprille
Jun 1, 1985·The American Review of Respiratory Disease·B FleuryJ Milic-Emili
Nov 1, 1994·American Journal of Respiratory and Critical Care Medicine·F MaltaisS B Gottfried
Jan 1, 1964·Journal of Applied Physiology·E SALAZAR, J H KNOWLES

❮ Previous
Next ❯

Citations

Dec 26, 2001·Anesthesiology·Muneyuki TakeuchiRobert M Kacmarek
Apr 10, 2003·American Journal of Respiratory and Critical Care Medicine·John J Marini, Roy G Brower
Nov 12, 2005·Intensive Care Medicine·Dimitris GeorgopoulosEumorfia Kondili
Aug 22, 2009·American Journal of Respiratory and Critical Care Medicine·Gopinathannair HarikumarGerrard F Rafferty
Jul 21, 2001·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·D DougenisA Maniati

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.