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Intensive Care Medicine

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01-03-2009 | Physiological and Technical Notes

A new automated method versus continuous positive airway pressure method for measuring pressure–volume curves in patients with acute lung injury

Authors: Enrique Piacentini, Marc Wysocki, Lluis Blanch

Published in: Intensive Care Medicine | Issue 3/2009

Abstract

Objective

To compare pressure–volume (P–V) curves obtained with the Galileo ventilator with those obtained with the CPAP method in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS).

Design

Prospective, observational study.

Setting

General critical care center.

Patients and participants

Patients with ALI/ARDS and receiving mechanical ventilation.

Interventions

Pressure–volume curves were obtained in random order with the CPAP technique and with the software PV Tool-2 (Galileo ventilator).

Measurements and results

In ten consecutive patients, airway pressure was measured by a pressure transducer and changes in lung volume were measured by respiratory inductive plethysmography. P–V curves were fitted to a sigmoidal equation with a mean R ² of 0.994 ± 0.003. Intraclass correlation coefficients were all >0.75 (P < 0.001 at all pressure levels). Lower (LIP) and upper inflection (UIP), and deflation maximum curvature (PMC) points calculated from the fitted variables showed a good correlation between methods with intraclass correlation coefficients of 0.98 (0.92, 0.99), 0.92 (0.69, 0.98), and 0.97 (0.86, 0.98), respectively (P < 0.001 in all cases). Bias and limits of agreement for LIP (0.51 ± 0.95 cmH₂O; −1.36 to 2.38 cmH₂O), UIP (0.53 ± 1.52 cmH₂O; −2.44 to 3.50 cmH₂O), and PMC (−0.62 ± 0.89 cmH₂O; −2.35 to 1.12 cmH₂O) obtained with the two methods in the same patient were clinically acceptable. No adverse effects were observed.

Conclusion

The PV Tool-2 built into the Galileo ventilator is equivalent to the CPAP method for tracing static P–V curves of the respiratory system in critically ill patients receiving mechanical ventilation.

Available only for authorised users

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Title: A new automated method versus continuous positive airway pressure method for measuring pressure–volume curves in patients with acute lung injury
Authors: Enrique Piacentini
Marc Wysocki
Lluis Blanch
Publication date: 01-03-2009
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 3/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1322-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A new automated method versus continuous positive airway pressure method for measuring pressure–volume curves in patients with acute lung injury

Abstract

Objective

Design

Setting

Patients and participants

Interventions

Measurements and results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Patients and participants

Interventions

Measurements and results

Conclusion

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