In Vivo Measurement of Tidal Volume During Non-invasive Respiratory Support by Continuous-Flow Helmet CPAP

IF 3 2区 医学 Q3 ENGINEERING, BIOMEDICAL
A. LoMauro, A. De Luca, P. Scarpazza, A. Aliverti
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Abstract

Recently, the interest in the Helmet interface during non-invasive respiratory support (NIRS) has increased due to the COVID-19 pandemic. During NIRS, positive end-expiratory pressure (PEEP) can be given as continuous positive airway pressure (CPAP), which maintains a positive airway pressure throughout the whole respiratory cycle with Helmet as an interface (H-CPAP). The main disadvantage of the H-CPAP is the inability to measure tidal volume (VT). Opto-electronic plethysmography (OEP) is a non-invasive technique that is not sensitive to gas compression/expansion inside the helmet. OEP acquisitions were performed on 28 healthy volunteers (14 females and 14 males) at baseline and during Helmet CPAP. The effect of posture (semi-recumbent vs. prone), flow (50 vs. 60 L/min), and PEEP (0 vs. 5 vs. 10 cmH2O) on the ventilatory and thoracic-abdominal pattern and the operational volumes were investigated. Prone position limited vital capacity, abdominal expansion and chest wall recruitment. A constant flow of 60 L/min reduced the need for the subject to ventilate while having a slight recruitment effect (100 mL) in the semi-recumbent position. A progressive increasing recruitment was found with higher PEEP but limited by the prone position. It is possible to accurately measure tidal volume during H-CPAP to deliver non-invasive ventilatory support using opto-electronic plethysmography during different clinical settings.

Abstract Image

使用持续流头盔式 CPAP 无创呼吸支持时的体内潮气量测量。
最近,由于 COVID-19 大流行,在无创呼吸支持(NIRS)过程中对头盔接口的兴趣有所增加。在无创呼吸支持过程中,呼气末正压(PEEP)可作为持续气道正压(CPAP)提供,在整个呼吸周期中保持气道正压,并将头盔作为接口(H-CPAP)。H-CPAP 的主要缺点是无法测量潮气量(VT)。光电胸压计(OEP)是一种无创技术,对头盔内的气体压缩/膨胀不敏感。对 28 名健康志愿者(14 名女性和 14 名男性)进行了基线和头盔 CPAP 期间的 OEP 采集。研究了姿势(半卧位与俯卧位)、流量(50 L/min 与 60 L/min)和 PEEP(0 cmH2O 与 5 cmH2O 与 10 cmH2O)对通气和胸腹模式以及操作量的影响。俯卧位限制了生命容量、腹部扩张和胸壁募集。60 升/分钟的恒定流量减少了受试者的通气需求,同时在半卧位时有轻微的募集效应(100 毫升)。随着 PEEP 的增加,招募效果逐渐增强,但受到俯卧位的限制。在不同的临床环境下,使用光电胸廓测量仪可以准确测量 H-CPAP 期间的潮气量,从而提供无创通气支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Biomedical Engineering
Annals of Biomedical Engineering 工程技术-工程:生物医学
CiteScore
7.50
自引率
15.80%
发文量
212
审稿时长
3 months
期刊介绍: Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.
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