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Intensive Care Medicine

Published in:

01-07-2004 | Original

Pattern of lung emptying and expiratory resistance in mechanically ventilated patients with chronic obstructive pulmonary disease

Authors: Eumorfia Kondili, Christina Alexopoulou, George Prinianakis, Nectaria Xirouchaki, Dimitris Georgopoulos

Published in: Intensive Care Medicine | Issue 7/2004

Abstract

Objectives

To study the pattern of lung emptying and expiratory resistance in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD).

Design

A prospective physiological study.

Setting

A 12-bed Intensive Care Unit.

Patients

Ten patients with acute exacerbation of COPD.

Interventions

At three levels of positive end-expiratory pressure (PEEP, 0, 5 and 10 cmH₂O) tracheal (Ptr) and airway pressures, flow (V’) and volume (V) were continuously recorded during volume control ventilation and airway occlusions at different time of expiration.

Measurements and results

V-V’ curves during passive expiration were obtained, expired volume was divided into five equal volume slices and the time constant (τ) and dynamic deflation compliance (Crs_dyn) of each slice was calculated by regression analysis of V-V’ and post-occlusion V-Ptr relationships, respectively. In each volume slice the existence or not of flow limitation was examined by comparing V-V’ curves with and without decreasing Ptr. For a given slice total expiratory resistance was calculated as τ/Crs_dyn, whereas expiratory resistance (Rrs) and time constant (τ_rs) of the respiratory system were subsequently estimated taken into consideration the presence of flow limitation. At zero PEEP, τ_rs increased significantly toward the end of expiration due to an increase in Rrs. PEEP significantly decreased Rrs at the end of expiration and resulted in a faster and relatively constant rate of lung emptying.

Conclusions

Patients with COPD exhibit a decrease in the rate of lung emptying toward the end of expiration due to an increase in Rrs. PEEP decreases Rrs, resulting in a faster and uniform rate of lung emptying.

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Title: Pattern of lung emptying and expiratory resistance in mechanically ventilated patients with chronic obstructive pulmonary disease
Authors: Eumorfia Kondili
Christina Alexopoulou
George Prinianakis
Nectaria Xirouchaki
Dimitris Georgopoulos
Publication date: 01-07-2004
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 7/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-004-2255-z

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Springer Medicine

Pattern of lung emptying and expiratory resistance in mechanically ventilated patients with chronic obstructive pulmonary disease

Abstract

Objectives

Design

Setting

Patients

Interventions

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Design

Setting

Patients

Interventions

Measurements and results

Conclusions

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