What Does a First Order Model Tell Us about PEEP Wave Maneuvers?

• 作者: B. Laufer J. Kretschmer K. M?ller P. D. Docherty Y. S. Chiew
• 来源期刊: 生物医学工程(英文)
• 学科: 医学
• 关键词: ARDS Positive End-Expiratory Pressure RECRUITMENT MANEUVERS First Order MODEL LUNG MECHANICS
• 年，卷（期）: swyxgcyw_2017,（5）
• 页码范围: 66-75
• 页数: 10页
• 分类号: R5

摘要

Patients with acute respiratory distress syndrome (ARDS) are currently treated with a lung protective ventilation strategy and the application of positive end-expiratory pressure (PEEP), sometimes in combination with recruitment maneuvers. In this study, the respiratory system elastance and airway resistance of each breath before, during and after a specific recruitment maneuver (PEEP wave maneuver) were analyzed in two patient groups, ARDS and control group. A reduction of elastance after the maneuver was observed in ARDS patients. In addition, only healthy lungs exhibited a reduction of the elastance during the course of the maneuver, while the lungs of ARDS patients didn’t show that reduction of elastance. The capability of PEEP wave maneuvers to improve lung ventilation was shown and the dynamic behavior of the elastance after the maneuver was illustrated. Healthy lungs adapt faster to changes in mechanical ventilation than the lungs of ARDS patients.