Airway and tissue mechanics in ventilated patients with pneumonia

Respir Physiol Neurobiol. 2010 Apr 30;171(2):101-9. doi: 10.1016/j.resp.2010.03.004. Epub 2010 Mar 7.

Abstract

We applied the low-frequency forced oscillation technique (LFOT) to measure respiratory impedance (Zrs) at various positive end-expiratory pressures (PEEPs) in 14 sedated and intubated patients with pneumonia classified into a mild (Group 1) and a severe group (Group 2) based on lung injury scores. The Zrs spectra were fit with the constant-phase (CP) model including Newtonian resistance (R(N)) and tissue damping (G) and elastance (H), a distributed airway resistance (DR) and a distributed tissue elastance (DH) model. Using the CP model, all parameters revealed a negative PEEP dependence (p<0.001) in Group 2 and H was higher in Group 2 (p=0.014). The variability of H from the DH model was nearly significantly larger in Group 1 (p=0.061). Following bronchodilator inhalation, G significantly decreased (p=0.009). Thus, the CP model provides a robust partitioning of Zrs into tissue properties and R(N), a surrogate for airway resistance, while the distributed models suggest that lung heterogeneity decreases with increasing PEEP.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adult
  • Aged
  • Aged, 80 and over
  • Airway Resistance* / drug effects
  • Bronchodilator Agents / administration & dosage
  • Female
  • Humans
  • Lung / drug effects
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Pneumonia / drug therapy
  • Pneumonia / physiopathology*
  • Positive-Pressure Respiration* / methods
  • Respiratory Mechanics* / drug effects
  • Severity of Illness Index

Substances

  • Bronchodilator Agents