0
Articles |

Evaluation of Respiratory Inductive Plethysmography in Controlled Ventilation : Measurement of Tidal Volume and PEEP-Induced Changes of End-Expiratory Lung Volume FREE TO VIEW

Peter Neumann; Jörg Zinserling; Christian Haase; Michael Sydow; Hilmar Burchardi
Author and Funding Information

From the Department of Anesthesiology, Emergency, and Intensive Care Medicine, University of Göttingen, Germany


1998 by the American College of Chest Physicians


Chest. 1998;113(2):443-451. doi:10.1378/chest.113.2.443
Text Size: A A A
Published online

Abstract

Study objective: To determine the accuracy of respiratory inductive plethysmography (RIP) with a respiratory monitor (Respitrace Plus; NIMS Inc., Miami) operating in the DC-mode for the measurement of tidal volumes (VT) and positive end-expiratory pressure (PEEP)-induced changes of end-expiratory lung volume (ΔEELV) in patients with normal pulmonary function, acute lung injury (ALI), and COPD during volume-controlled ventilation.

Design: Prospective comparison of RIP with pneumotachography (PT) for assessment of VT and with multibreath nitrogen washout procedure (N2WO) for determination of ΔEELV as reference methods.

Setting: Mixed ICU at a university hospital.

Patients: Thirty-one sedated and paralyzed patients: 12 patients with normal pulmonary function mechanically ventilated after major surgery, 10 patients with respiratory failure due to ALI, and 9 patients with a known history of COPD ventilated after surgery or because of respiratory failure due to bronchopulmonary infection.

Interventions: Stepwise increase of PEEP from 0 to 5 to 10 cm H2O and reduction to 0 cm H2O again. On each PEEP level, N2WO was performed.

Measurements and main results: The baseline drift of RIP averaged 25.4±29.1 mL/min but changed over a wide range even in single patient measurements. Determination of VT for single minutes revealed that 66.5% and 90.0% of all values were accurate within a range of ±10% and ±20%, respectively. The deviation for VT measurements between RIP and PT in patients with COPD was significantly (p<0.05) higher compared to patients with ALI or normal pulmonary function. The difference of ΔEELV between RIP and N2WO was 11.6±174.1 mL with correlation coefficients of 0.77 (postoperative and COPD patients) and 0.86 (ALI patients). However, just 25.8% and 46.2% were precise within ±10% and ±20%, respectively. ΔEELV determination in COPD patients differed more between RIP and N2WO than in the other groups, but this was not significant.

Conclusion: In a mixed group of patients undergoing controlled ventilation, RIP using the Respitrace Plus monitor was not consistently precise enough for quantitative evaluation of VT and EELV when compared to our reference methods. This was most evident in patients with COPD. For long-term volume measurements, a better control of the baseline drift of RIP should be achieved.


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543