[Respiratory function monitoring in a child on mechanical respiratory ventilation. 2: compliance, resistance, dynamic hyperinflation, pulmonary dead-space, work of breathing].
Several parameters can be used to study respiratory mechanics in children on mechanical ventilation. Compliance is a measure of the distensibility of the respiratory system. In mechanical ventilation two measures of compliance can be used. Static compliance (pulmonary distensibility) can be measured in volume modes by the application of an inspiratory pause with the respiratory system at rest (sedated patients without inspiratory effort). Dynamic compliance does not require an inspiratory pause and the respiratory system need not be at rest. Compliance can be calculated numerically or expressed graphically in the volume-pressure curve. Many respirators can calculate inspiratory and expiratory airway resistance (including endotracheal tube resistance). Several measures can be used to detect dynamic hyperinflation (intrinsic PEEP, auto-PEEP, trapped air volume) after application of an expiratory pause. The latest respirators can perform these measurements almost automatically. Work of breathing and respiratory effort can also be analyzed by measuring several parameters (pressure-time product, imposed work of breathing, P 0.1, maximum inspiratory pressure). However, these measures have not yet been standardized in children.
López-Herce Cid
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Sección de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, España. pielvi@retemail.es
D000208:Acute Disease; D000403:Airway Resistance / Q000502:physiology*; D001696:Biomechanical Phenomena; D002648:Child; D006801:Humans; D006985:Hyperventilation / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D008170:Lung Compliance; D008171:Lung Diseases / Q000150:complications; D012121:Respiration, Artificial / Q000379:methods; D012126:Respiratory Dead Space / Q000502:physiology*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012720:Severity of Illness Index