Effects of different continuous positive airway pressure devices and periodic hyperinflations on respiratory function

Paolo Pelosi, Davide Chiumello, Enrico Calvi, Paolo Taccone, Nicola Bottino, Mauro Panigada, Paolo Cadringher, Luciano Gattinoni

Research output: Contribution to journalArticle

Abstract

Objective: To compare the effect on respiratory function of different continuous positive airway pressure systems and periodic hyperinflations in patients with respiratory failure. Design: Prospective Setting: Hospital intensive care unit. Patients: Sixteen intubated patients (eight men and eight women, age 54 ± 18 yrs, PaO2/FlO2 277 ± 58 torr, positive end-expiratory pressure 6.2 ± 2.0 cm H2O). Interventions: We evaluated continuous flow positive airway pressure systems with high or low flow plus a reservoir bag equipped with spring-loaded mechanical or underwater seal positive end-expiratory pressure valve and a continuous positive airway pressure by a Servo 300 C ventilator with or without periodic hyperinflations (three assisted breaths per minute with constant inspiratory pressure of 30 cm H2O over positive end-expiratory pressure). Measurements and Main Results: We measured the respiratory pattern, work of breathing, dyspnea sensation, end-expiratory lung volume, and gas exchange. We found the following: a) Work of breathing and gas exchange were comparable between continuous flow systems; b) the ventilator continuous positive airway pressure was not different compared with continuous flow systems; and c) continuous positive airway pressure with periodic hyperinflations reduced work of breathing (10.7 ± 9.5 vs. 6.3 ± 5.7 J/min, p <.05) and dyspnea sensation (1.6 ± 1.2 vs. 1.1 ± 0.8 cm, p <.05) increased end-expiratory lung volume (1.6 ± 0.8 vs. 2.0 ± 0.9 L, p <.05) and PaO2 (100 ± 21 vs. 120 ± 25 torr, p <.05) compared with ventilator continuous positive airway pressure. Conclusions: The continuous flow positive airway pressure systems tested are equally efficient; a ventilator can provide satisfactory continuous positive airway pressure; and the use of periodic hyperinflations during continuous positive airway pressure can improve respiratory function and reduce the work of breathing.

Original languageEnglish
Pages (from-to)1683-1689
Number of pages7
JournalCritical Care Medicine
Volume29
Issue number9
Publication statusPublished - 2001

Keywords

  • Acute respiratory failure
  • Continuous positive airway pressure
  • Dyspnea sensation
  • End expiratory lung volume
  • Gas exchange
  • Periodic hyperinflations
  • Positive end-expiratory pressure
  • Pressure-controlled synchronous intermittent mandatory ventilation
  • Respiratory function
  • Work of breathing

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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