A new method for P0.1 measurement using standard respiratory equipment.
The airway occlusion pressure, P0.1, is an index for the neuro-muscular activation of the respiratory system. It has been shown to be a very useful indicator for the ability of patients receiving ventilatory support to be weaned from mechanical ventilation. Since the standard measurement technique for P0.1 determination is technically complex, it is not widely available for clinical purposes. For that reason a P0.1 measurement technique was developed as an integrated function in a standard respirator (Evita, Dräger, Lübeck, Germany). This technique is easy to use and does not need any further equipment. We validated this new technique by comparing it to standard P0.1 measurements in a mechanical lung model as well as in ventilated patients. In the lung model we found a correlation between the Evita measurement and standard measurements of r = 0.99. In 6 ventilated patients the correlation was r = 0.78. Since the Evita P0.1 and the standard measurement had to be performed during two different breaths, this little poorer correlation in patients may be due to a significant breath-by-breath variability in P0.1. Comparing the Evita P0.1 and the standard measurement within one breath resulted in a clearly better correlation (r = 0.89). We conclude that this new measurement technique provides an easy and accurate P0.1 measurement using standard respiratory equipment when tested in a lung model. In patient measurements the method is less precise, which is probably due to the variable waveforms of the inspiratory driving pressure seen in patients, for example when intrinsic PEEP is present.(ABSTRACT TRUNCATED AT 250 WORDS)
Kuhlen
R
R
Department of Anesthesiology and Operative Intensive Care Medicine, University Clinic Rudolf Virchow, Free University, Berlin, Germany.
Hausmann
S
S
Pappert
D
D
Slama
K
K
Rossaint
R
R
Falke
K
K
D000403:Airway Resistance; D006801:Humans; D008365:Manometry / Q000295:instrumentation / Q000379:methods*; D008953:Models, Anatomic; D015203:Reproducibility of Results; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000628:therapy; D014160:Transducers, Pressure; D015300:Ventilator Weaning; D014939:Work of Breathing