title: Dynamic and quasi-static lung mechanics system for gas-assisted and liquid-assisted ventilation.
abstract: Our aim was to develop a computerized system for real-time monitoring of lung mechanics measurements during both gas and liquid ventilation. System accuracy was demonstrated by calculating regression and percent error of the following parameters compared to standard device: airway pressure difference (Delta P(aw)), respiratory frequency (f(R) ), tidal volume (V(T)), minute ventilation (V'(E)), inspiratory and expiratory maximum flows (V'(ins,max), V'(exp,max)), dynamic lung compliance (C(L,dyn) ), resistance of the respiratory system calculated by method of Mead-Whittenberger (R(rs,MW)) and by equivalence to electrical circuits (R(rs,ele)), work of breathing (W(OB)), and overdistension. Outcome measures were evaluated as function of gas exchange, cardiovascular parameters, and lung mechanics including mean airway pressure (mP(aw)). Delata P(aw), V(T), V'(ins,max), V'(exp,max), and V'(E) measurements had correlation coefficients r = 1.00, and %error < 0.5%. f(R), C(L,dyn), R(rs,MW), R(rs,ele), and W(OB) showed r > or = 0.98 and %error < 5%. Overdistension had r = 0.87 and %error < 15%. Also, resistance was accurately calculated by a new algorithm. The system was tested in rats in which lung lavage was used to induce acute respiratory failure. After lavage, both gas- and liquid-ventilated groups had increased mP(aw) and W(OB), with decreased V(T), V'(E), C(L,dyn), R(rs,MW), and R(rs,ele) compared to controls. After 1-h ventilation, both injured group had decreased V(T), V'(E) , and C(L,dyn), with increased mP(aw), R(rs,MW), R(rs,ele), and W(OB) . In lung-injured animals, liquid ventilation restored gas exchange, and cardiovascular and lung functions. Our lung mechanics system was able to closely monitor pulmonary function, including during transitions between gas and liquid phases.
authors.affiliation: Research Unit in Experimental Pulmonary Physiology, Hospital of Cruces, Basque Country Health's Service, Bilbao 48903, Spain. franciscojose.alvarezdiaz@osakidetza.net
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Alvarez
authors.forename: Elena
authors.initials: E
authors.lastname: Gastiasoro
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Rey-Santano
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Gomez-Solaetxe
authors.forename: Nelson G
authors.initials: NG
authors.lastname: Publicover
authors.forename: Juan L
authors.initials: JL
authors.lastname: Larrabe