Quantifying neonatal pulmonary mechanics in mechanical ventilation

Type of content
Journal Article
Thesis discipline
Degree name
Publisher
Elsevier BV
Journal Title
Journal ISSN
Volume Title
Language
English
Date
2019
Authors
Kim KT
Knopp J
Dixon B
Chase, Geoff
Abstract

© 2019 Elsevier Ltd Background: Mechanical Ventilation (MV) is an important intensive care therapy. It is often used in neonatal intensive care units (NICUs) to treat respiratory distress syndrome. This paper uses model-based methods in a first in-depth attempt to quantify the underlying lung mechanics in NICU patients. Methods: Up to 24 h of airway flow and pressure data were recorded in 10 mechanically ventilated patients. A single compartment model with added term for the pressure drop across the endotracheal tube is used to identify breath-specific elastance and resistance. Result: The model was fitted to 422,475 (79%) breaths of 535,428, with the remainder comprising a range of asynchronies. Elastance was median 1.62 [IQR: 0.85–2.25] cmH 2 O/ml and resistance 5.22 [0.00–33.85] cmH 2 O.s/ml. Patients treated with surfactant therapy had significantly lower specific elastance (adjusting for weight) than those without (p ≤ 0.01). A decrease in elastance with increasing weight was also noted. Conclusion: The single compartment model was successfully fit with low error. The subgroup cohorts showed expected trends and further validates the identified model values. There was significant breath-to-breath variability in elastance within and between patients.

Description
Citation
Kim KT, Knopp J, Dixon B, Chase G (2019). Quantifying neonatal pulmonary mechanics in mechanical ventilation. Biomedical Signal Processing and Control. 52. 206-217.
Keywords
Neonatal Intensive Care Unit (NICU), elastance, pulmonary mechanics, neonatal, respiratory
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Fields of Research::40 - Engineering::4003 - Biomedical engineering::400303 - Biomechanical engineering
Rights
Creative Commons Attribution Non-Commercial No Derivatives License