PMID: 6352196Oct 1, 1983

Positive airway pressure in patients receiving intermittent mandatory ventilation at zero rate. The role in weaning in chronic obstructive pulmonary disease

Chest
F A KhanR Iorio

Abstract

Over a 20-month period, we treated 180 mechanically ventilated patients in our respiratory intensive care unit. Among these patients, we observed an interesting previously unreported phenomenon in 20 patients with severe chronic obstructive disease. During the weaning from mechanical ventilators of these 20 patients, there was a marked clinical deterioration when the mode of ventilation was changed from intermittent mandatory ventilation (IMV) at zero rate to that of a T-tube setup. To explain this previously unreported observation, we studied and compared nine different intubated patients for possible differences in airway pressure between IMV set up at zero rate and a T tube. We observed that peak airway pressures were greater on IMV at zero rate compared to the peak airway pressures on the T piece in all nine patients. At the end of expiration, seven out of the nine patients had higher airway pressures on IMV at zero rate compared to the T tube. These differences in the peak airway pressures and end-expiratory pressures were statistically significant in both groups. In spite of the obvious limitation of extrapolating the experimental results obtained in one group of patients to explain the clinical observations made in anoth...Continue Reading

References

Jul 1, 1977·Critical Care Medicine·G B SchmidtJ Feder
Sep 1, 1977·Anesthesia and Analgesia·J S Gillick
Apr 24, 1975·The New England Journal of Medicine·T W Feeley, J Hedley-Whyte
Jan 1, 1976·British Journal of Diseases of the Chest·A H CampbellB M Jones
Jun 1, 1973·Chest·S A Sahn, S Lakshminarayan
Jul 1, 1981·Anesthesiology·S F QuanR M Schlobohm

Related Concepts

Biphasic Intermittent Positive Airway Pressure
Lung Diseases, Obstructive
Peak Expiratory Flow Rate Measurement
Positive End-Expiratory Pressure
Weaning

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