Exhaled tidal volume overestimation in mechanically ventilated patients with large cardiogenic oscillation

Critical Care Medicine
Hideaki ImanakaMasaji Nishimura

Abstract

In postcardiac surgery patients, we often noticed that monitored tidal volumes exceeded the ventilator settings. We investigated whether cardiogenic oscillation causes overestimation of tidal volume. Prospective, observational, clinical study. Surgical intensive care unit in a national heart institute. Eight postcardiac surgery patients (age 13-70). Patients were paralyzed and received flow-triggered volume-controlled ventilation with a tidal volume of 10 mL/kg. In random order, two types of ventilator (Bird 8400 STi and Servo-300) and two respiratory rates (5 and 10 breaths/min) were applied to each patient via a disposal ventilatory circuit and heat-and-moisture exchanger. For each ventilator, we adjusted the flow-triggering sensitivity to prevent autotriggering due to cardiogenic oscillation: 10 L/min for the Bird 8400 STi and green zone for the Servo-300. The magnitude of cardiogenic oscillation during mechanical ventilation was defined as peak expiratory flow fluctuation at end-expiration. We recorded tidal volume using the monitoring devices on the ventilators and calculated the discrepancy from the set tidal volume. Cardiogenic oscillation was significantly greater with the Bird 8400STi (4.0 +/- 1.8 L/min) than with the ...Continue Reading

References

Oct 31, 2002·American Journal of Respiratory and Critical Care Medicine·Peter Q EichackerCharles Natanson

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