Abstract:
OBJECTIVES:Children with peripheral airways obstruction suffer the negative effects of intrinsic positive end-expiratory pressure: increased work of breathing and difficulty triggering assisted ventilatory support. We examined whether external positive end-expiratory pressure to offset intrinsic positive end-expiratory pressure decreases work of breathing in children with peripheral airways obstruction. The change in work of breathing with incremental pressure support was also tested. DESIGN AND SETTING:Prospective clinical trial in a pediatric intensive care unit. PATIENTS:Eleven mechanically ventilated, spontaneously breathing children with peripheral airways obstruction. INTERVENTIONS:Work of breathing (using pressure-rate product as a surrogate) was measured in three tiers: (a) Increasing pressure support over zero end-expiratory pressure. (b) Increasing applied positive end-expiratory pressure and fixed pressure support. The level of applied positive end-expiratory pressure at which pressure-rate product was least determined the compensatory positive end-expiratory pressure. (c) Increasing pressure support over compensatory (fixed) positive end-expiratory pressure. MEASUREMENTS AND RESULTS:Increases in pressure support alone decreased pressure-rate product from mean 724+/-311 to 403+/-192 cmH2O/min. Applied positive end-expiratory pressure alone decreased pressure-rate product from mean 608+/-301 to 250+/-169 cmH2O/min. The lowest pressure-rate product (136+/-128 cmH2O/min) was achieved using compensatory positive end-expiratory pressure (12+/-4 cmH2O) with pressure support 16 cmH2O. CONCLUSIONS:For children with peripheral airways obstruction who require assisted ventilation, work of breathing during spontaneous breaths is decreased by the application of either compensatory positive end-expiratory pressure or pressure support.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Graham AS,Chandrashekharaiah G,Citak A,Wetzel RC,Newth CJdoi
10.1007/s00134-006-0445-6subject
Has Abstractpub_date
2007-01-01 00:00:00pages
120-7issue
1eissn
0342-4642issn
1432-1238journal_volume
33pub_type
临床试验,杂志文章abstract::This report identifies some of the risk factors underlying the acquisition of hospital infections in patients admitted to Intensive Care Units (ICUs). Infection rates vary in different institutes and in different types of ICUs. Patients are particularly prone to septicaemia and respiratory infections and the underlyin...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01709700
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abstract:OBJECTIVE:To assess the ability of the Clinical Risk Index for Babies (CRIB) to predict long-term neurodevelopmental impairment in very low birth weight (VLBW) infants. DESIGN:Single-center cohort study. SETTING:Tertiary neonatal care hospital and follow-up clinic. PATIENTS:Four hundred fifty-five VLBW infants conse...
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pub_type: 杂志文章
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journal_title:Intensive care medicine
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doi:10.1007/s00134-007-0833-6
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更新日期:2011-05-01 00:00:00
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更新日期:2001-03-01 00:00:00
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更新日期:2013-04-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2016-03-01 00:00:00
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更新日期:2004-02-01 00:00:00
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更新日期:2001-01-01 00:00:00
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更新日期:2005-08-01 00:00:00
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更新日期:2013-01-01 00:00:00
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更新日期:2003-10-01 00:00:00
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更新日期:2014-02-01 00:00:00
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更新日期:2005-12-01 00:00:00
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更新日期:2005-03-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1995-07-01 00:00:00
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更新日期:1998-08-01 00:00:00