Measurements Obtained From Esophageal Balloon Catheters Are Affected by the Esophageal Balloon Filling Volume in Children With ARDS.

Abstract:

BACKGROUND:Esophageal balloon inflation volume may affect the accuracy of transpulmo-nary pressure estimates in adults, but the effect is unknown in pediatrics. Using a combination bench and human study, we sought to determine a range of optimal filling volumes for esophageal balloon catheters and to derive a technique to inflate catheters to yield the most accurate estimates of pleural pressure. METHODS:In the laboratory study, we evaluated 4 pediatric and adult esophageal balloon catheters, a liquid-filled catheter, and a micro-tip catheter, both with and without a model esophagus. We compared the measured esophageal pressure for each type of catheter within a pressurized chamber. Esophageal balloon catheters were also tested by manipulating the esophageal balloon inflation volume, and we attempted to derive a filling-volume technique that would assure accuracy. We then tested the feasibility of this technique in 5 mechanically ventilated pediatric subjects with ARDS. RESULTS:In the laboratory study, smaller inflation volumes underestimated the chamber pressure at higher chamber pressures, and larger inflation volumes overestimated the chamber pressure at lower chamber pressures. Using an optimal filling-volume technique resulted in a mean total error that ranged from -0.53 to -0.10 cm H2O. The optimal filling-volume values for the pediatric catheters were 0.2-0.6 mL, and 0.4-0.8 mL for the adult catheters. When correctly positioned and calibrated, the micro-tip transducer and liquid-filled catheters were within ± 1 cm H2O of chamber pressure for all ranges of pressure. In the clinical study, high variability in measured esophageal pressure and subsequent transpulmonary pressure during exhalation and during inhalation was observed within the manufacturer's recommended esophageal balloon inflation ranges. CONCLUSIONS:Manufacturer-recommended esophageal balloon inflation ranges do not assure accuracy. Individual titration of esophageal balloon volume may improve accuracy. Better esophageal catheters are needed to provide reliable esophageal pressure measurements in children.

journal_name

Respir Care

journal_title

Respiratory care

authors

Hotz JC,Sodetani CT,Van Steenbergen J,Khemani RG,Deakers TW,Newth CJ

doi

10.4187/respcare.05685

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

177-186

issue

2

eissn

0020-1324

issn

1943-3654

pii

respcare.05685

journal_volume

63

pub_type

杂志文章
  • Effect of high-flow nasal cannula and body position on end-expiratory lung volume: a cohort study using electrical impedance tomography.

    abstract:BACKGROUND:Electrical impedance tomography measures changes in lung impedance, which are mainly related to changes in lung volume. We used electrical impedance tomography to investigate the effects of high-flow nasal cannula (HFNC) and body position on global and regional end-expiratory lung impedance variation (ΔEELI)...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.02086

    authors: Riera J,Pérez P,Cortés J,Roca O,Masclans JR,Rello J

    更新日期:2013-04-01 00:00:00

  • Frequency and causes of combined obstruction and restriction identified in pulmonary function tests in adults.

    abstract:BACKGROUND:The frequency of combined obstruction and restriction identified in pulmonary function tests has not been well described. Moreover, although the causes of combined-obstruction-and-restriction patterns are known, the frequency of the various etiologies has received little attention. METHODS:We retrospectivel...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Diaz-Guzman E,McCarthy K,Siu A,Stoller JK

    更新日期:2010-03-01 00:00:00

  • Extracorporeal membrane oxygenation for neonatal respiratory failure.

    abstract::Extracorporeal membrane oxygenation (ECMO) is a form of cardiopulmonary bypass adapted for long-term use. Blood is drained from the patient, pumped through an artificial lung or membrane where gas exchange is augmented, and then re-infused back to the patient. ECMO provides support for the neonate with severe respirat...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Betit P,Craig N

    更新日期:2009-09-01 00:00:00

  • Comparison of Vibrating Mesh, Jet, and Breath-Enhanced Nebulizers During Mechanical Ventilation.

    abstract:BACKGROUND:This study compared 3 nebulizer technologies for inter- and intradevice reproducibility, humidification, and fill volume sensitivity during mechanical ventilation: a breath-enhanced jet nebulizer, a vibrating mesh nebulizer, and a jet nebulizer. The breath-enhanced jet nebulizer featured a new design located...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.07639

    authors: Ashraf S,McPeck M,Cuccia AD,Smaldone GC

    更新日期:2020-10-01 00:00:00

  • Physiological Responses During Field Walking Tests in Adults with Bronchiectasis.

    abstract:BACKGROUND:Field walking tests are commonly used in patients with chronic pulmonary diseases for assessment of functional capacity. However, the physiological demands and magnitude of desaturation on 6-min walk test (6MWT), incremental shuttle walk test (ISWT), and endurance shuttle walk test (ESWT) have not been inves...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.07171

    authors: Corso SD,Boldorini JC,de Camargo AA,José A,Rached SZ,Athanazio RA,Stelmach R,Holland AE

    更新日期:2020-05-01 00:00:00

  • An unusual cause of refractory hypoxemia in cirrhosis.

    abstract::Pulmonary gas exchange abnormalities and refractory hypoxemia cause myriad difficulties in patients with chronic liver disease. In addition to intrinsic cardiopulmonary diseases and hepatopulmonary syndrome, some unusual pathophysiological mechanisms in patients with portosystemic collaterals might contribute to hypox...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.03529

    authors: Patidar Y,Kumar S

    更新日期:2015-03-01 00:00:00

  • Pulmonary rehabilitation for chronic obstructive pulmonary disease: a scientific and political agenda.

    abstract::Pulmonary rehabilitation (PR) is the standard of care for patients suffering chronic obstructive pulmonary disease (COPD). This report describes and defines PR and reviews the evidence regarding the efficacy of PR. COPD management guidelines that include PR have been published by the European Respiratory Society, the ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Fahy BF

    更新日期:2004-01-01 00:00:00

  • Effect of intrapulmonary percussive ventilation on mucus clearance in duchenne muscular dystrophy patients: a preliminary report.

    abstract:OBJECTIVE:To determine the effects of intrapulmonary percussive ventilation (IPV) on mucus clearance in tracheostomized Duchenne muscular dystrophy patients. METHODS:We studied 8 patients, 5 of whom had mucus hypersecretion (> 30 mL/d). In a randomized, cross-over study we compared assisted mucus clearance techniques ...

    journal_title:Respiratory care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Toussaint M,De Win H,Steens M,Soudon P

    更新日期:2003-10-01 00:00:00

  • Inhalable drugs for systemic therapy.

    abstract::Although oral and injectable drug formulations still dominate the market, interest in pulmonary delivery has been rising steadily. Given patients' desire for an alternative to injections, and recent advances in aerosol science and pulmonary medicine, the potential for improved disease management outcomes by using aero...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:

    authors: Corkery K

    更新日期:2000-07-01 00:00:00

  • Mucolytics, expectorants, and mucokinetic medications.

    abstract::In health, the airways are lined by a layer of protective mucus gel that sits atop a watery periciliary fluid. Mucus is an adhesive, viscoelastic gel, the biophysical properties of which are largely determined by entanglements of long polymeric gel-forming mucins, MUC5AC and MUC5B. This layer entraps and clears bacter...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Rubin BK

    更新日期:2007-07-01 00:00:00

  • Variation Among Spirometry Interpretation Algorithms.

    abstract::Several algorithms exist to facilitate spirometric interpretation in clinical practice, yet there is a lack of consensus on how spirometric criteria for asthma, COPD, and restrictive disorders should be incorporated into spirometry interpretation algorithms suitable for use in day-to-day primary care management. The p...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.07294

    authors: D'Urzo KA,Mok F,D'Urzo AD

    更新日期:2020-10-01 00:00:00

  • Noninvasive ventilation for acute respiratory failure: a national survey of Veterans Affairs hospitals.

    abstract:BACKGROUND:The utilization of noninvasive ventilation (NIV) in the Veterans Affairs health-care system is not well characterized. A survey of physicians and respiratory therapists was conducted to better understand its use. METHODS:Three hospitals in each of 21 Veterans Affairs networks were selected based on severity...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Bierer GB,Soo Hoo GW

    更新日期:2009-10-01 00:00:00

  • Sleep-disordered breathing and COPD: the overlap syndrome.

    abstract::Sleep-disordered breathing (mainly obstructive sleep apnea [OSA]) and COPD are among the most common pulmonary diseases, so a great number of patients have both disorders; this "overlap syndrome" causes more severe nocturnal hypoxemia than either disease alone. This common combination of OSA and COPD has important imp...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:

    authors: Owens RL,Malhotra A

    更新日期:2010-10-01 00:00:00

  • Should PEEP Titration Be Based on Chest Mechanics in Patients With ARDS?

    abstract::Functional residual capacity (FRC) is essentially the alveolar volume and a determinant of both oxygenation and respiratory system compliance (CRS). ARDS decreases FRC, and sufficient PEEP restores FRC; thus, assessments of PEEP by its impact on oxygenation and CRS are intimately linked. PEEP also can ameliorate or ag...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.04657

    authors: Kallet RH

    更新日期:2016-06-01 00:00:00

  • Safety and efficacy of short-term intrapulmonary percussive ventilation in patients with bronchiectasis.

    abstract:BACKGROUND:Treatment of bronchiectasis includes drugs, oxygen therapy, and bronchial-clearance maneuvers. OBJECTIVE:To assess the safety and efficacy of intrapulmonary percussive ventilation (IPV) compared to traditional standard chest physical therapy in patients with bronchiectasis and productive cough. METHODS:In ...

    journal_title:Respiratory care

    pub_type: 杂志文章,随机对照试验

    doi:10.4187/respcare.01098

    authors: Paneroni M,Clini E,Simonelli C,Bianchi L,Degli Antoni F,Vitacca M

    更新日期:2011-07-01 00:00:00

  • Feasibility and potential cost/benefit of routine isoflurane sedation using an anesthetic-conserving device: a prospective observational study.

    abstract:BACKGROUND:Inhaled sedation is efficient and easily controllable; in low concentrations it causes minimal changes in the patient and very little interference with hemodynamics. Awakening after inhaled sedation is quick and predictable. The major reason inhaled sedation has not become widely used in intensive care is th...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: L'her E,Dy L,Pili R,Prat G,Tonnelier JM,Lefevre M,Renault A,Boles JM

    更新日期:2008-10-01 00:00:00

  • Use of a single ventilator to support 4 patients: laboratory evaluation of a limited concept.

    abstract:INTRODUCTION:A mass-casualty respiratory failure event where patients exceed available ventilators has spurred several proposed solutions. One proposal is use of a single ventilator to support 4 patients. METHODS:A ventilator was modified to allow attachment of 4 circuits. Each circuit was connected to one chamber of...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.01236

    authors: Branson RD,Blakeman TC,Robinson BR,Johannigman JA

    更新日期:2012-03-01 00:00:00

  • Do directed cough maneuvers improve cough effectiveness in the early period after open heart surgery? Effect of thoracic support and maximal inspiration on cough peak expiratory flow, cough expiratory volume, and thoracic pain.

    abstract:BACKGROUND:Directed cough maneuvers are often included in physiotherapy management aimed at preventing postoperative pulmonary complications after open heart surgery, but there is little scientific evidence of the effectiveness of directed cough maneuvers. METHODS:We conducted a randomized intra-subject crossover tria...

    journal_title:Respiratory care

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Fiore JF Jr,Chiavegato LD,Denehy L,Paisani DM,Faresin SM

    更新日期:2008-08-01 00:00:00

  • Positive expiratory pressure changes aerosol distribution in patients with cystic fibrosis.

    abstract:HYPOTHESIS:We hypothesized that aerosol distribution in the lungs of patients with cystic fibrosis changes with positive expiratory pressure (PEP). METHODS:Eight patients were randomized to one of 2 conditions. On one study day, patients inhaled saline aerosol containing 99mtechnetium generated by a Pari LC Plus nebul...

    journal_title:Respiratory care

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Laube BL,Geller DE,Lin TC,Dalby RN,Diener-West M,Zeitlin PL

    更新日期:2005-11-01 00:00:00

  • Esophageal Pressure Versus Gas Exchange to Set PEEP During Intraoperative Ventilation.

    abstract:BACKGROUND:Pneumoperitoneum and Trendelenburg position affect respiratory system mechanics and oxygenation during elective pelvic robotic surgery. The primary aim of this randomized pilot study was to compare the effects of a conventional low tidal volume ventilation with PEEP guided by gas exchange (VGas-guided) versu...

    journal_title:Respiratory care

    pub_type: 杂志文章,随机对照试验

    doi:10.4187/respcare.07238

    authors: Cammarota G,Lauro G,Sguazzotti I,Mariano I,Perucca R,Messina A,Zanoni M,Garofalo E,Bruni A,Della Corte F,Navalesi P,Bignami E,Vaschetto R,Mojoli F

    更新日期:2020-05-01 00:00:00

  • Management of acute lung injury: sharing data between adults and children.

    abstract::As the basis for this paper, it must be acknowledged that children are not simply small adults. But this acknowledgment must go further: infants are not simply small adolescents. As data for pediatric mechanical ventilation, in general, and the management for pediatric acute lung injury, more specifically, are very l...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.01413

    authors: Cheifetz IM

    更新日期:2011-09-01 00:00:00

  • Determinants of patient adherence to an aerosol regimen.

    abstract::Patient adherence with prescribed inhaled therapy is related to morbidity and mortality. The terms "compliance" and "adherence" are used in the literature to describe agreement between prescribed medication and patient practice, with "adherence" implying active patient participation. Patient adherence with inhaled med...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:

    authors: Rau JL

    更新日期:2005-10-01 00:00:00

  • Recommendations of the Fifth Oxygen Consensus Conference. Writing and Organizing Committees.

    abstract::It should be recognized that the advent of LTOT created a new health care system that is based on powerful scientific data. Oxygen therapy studies such as those by the Nocturnal Oxygen Therapy Trial Group and the British Medical Research Council study clearly demonstrated that LTOT improves both the length and quality...

    journal_title:Respiratory care

    pub_type: 共识发展会议,杂志文章,评审

    doi:

    authors: Petty TL,Casaburi R

    更新日期:2000-08-01 00:00:00

  • Filamin A mutation may be associated with diffuse lung disease mimicking bronchopulmonary dysplasia in premature newborns.

    abstract::Bronchopulmonary dysplasia (BPD) is a common long-term complication in premature newborns requiring ventilatory support and is the most common cause of chronic diffuse lung disease in this population. We present the clinical course of a premature newborn with a complicated neonatal respiratory course that was initiall...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.02847

    authors: Lord A,Shapiro AJ,Saint-Martin C,Claveau M,Melançon S,Wintermark P

    更新日期:2014-11-01 00:00:00

  • Microalbuminuria in Subjects With COPD: Relationship to the New Version of Global Initiative for Chronic Obstructive Lung Disease Staging.

    abstract:BACKGROUND:Microalbuminuria, used as a marker of endothelial dysfunction, is a predictor of mortality for any reason and of cardiovascular events. Recent research on the management of COPD has focused more on comorbidities, including cardiovascular events. The objective of this study was to investigate the incidence of...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.05168

    authors: Bozkus F,Dikmen N,Samur A

    更新日期:2017-03-01 00:00:00

  • Imaging of acute respiratory distress syndrome.

    abstract::Chest radiography and computed tomography (CT) have a crucial role to play in the diagnosis and management of acute respiratory distress syndrome (ARDS). The identification of pulmonary opacification is a requirement for the definition of ARDS on the chest radiograph, while CT has a role to play, not only in the diag...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.01731

    authors: Sheard S,Rao P,Devaraj A

    更新日期:2012-04-01 00:00:00

  • Emergency Department Airway Management for Status Asthmaticus With Respiratory Failure.

    abstract:BACKGROUND:Data are limited regarding current practice and outcomes for emergency department airway management in status asthmaticus. This paper describes the foremost methods and outcomes of airway management in patients in the emergency department who required intubation for status asthmaticus. METHODS:We analyzed a...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.07723

    authors: Godwin HT,Fix ML,Baker O,Madsen T,Walls RM,Brown CA 3rd

    更新日期:2020-12-01 00:00:00

  • Prognostic value of plateau pressure below 30 cm H2O in septic subjects with acute respiratory failure.

    abstract:BACKGROUND:Ventilation with low tidal volume is recommended for patients with acute lung injury. Current guidelines suggest limiting plateau pressure (Pplat) to < 30 cm H2O for septic patients needing mechanical ventilation. The aim of this study was to determine whether Pplat within the first 24 h of ICU admission is ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.03138

    authors: Chan MC,Tseng JS,Chiu JT,Hsu KH,Shih SJ,Yi CY,Wu CL,Kou YR

    更新日期:2015-01-01 00:00:00

  • The physiologic effects of noninvasive ventilation.

    abstract::The physiologic effects of noninvasive ventilation (NIV) on work of breathing (WOB) and breathing pattern, respiratory-system mechanics, and hemodynamic function were examined via a literature review of clinical studies done between 1990 and 2008. Forty-one relevant studies were found; the majority examined patients w...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Kallet RH,Diaz JV

    更新日期:2009-01-01 00:00:00

  • Impulse oscillometry for leukotriene D4 inhalation challenge in asthma.

    abstract:BACKGROUND:The value of impulse oscillometry (IOS) for bronchial provocation testing is poorly defined. We investigated the positive threshold derived from the parameters and diagnostic power of IOS for asthma with the leukotriene D(4) bronchial provocation test. METHODS:We enrolled 62 subjects with asthma and 21 heal...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.02417

    authors: Guan WJ,Zheng JP,Gao Y,Jiang CY,Shi X,Xie YQ,Liu QX,Jiang M,An JY,Yu XX,Liu WT,Zhong LP,Wu ZP,Zhong NS

    更新日期:2013-12-01 00:00:00