Accuracy and precision of end expiratory lung volume measurements by automated nitrogen washout/washin technique in patients with acute respiratory distress syndrome. - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles Critical Care Year : 2011

Accuracy and precision of end expiratory lung volume measurements by automated nitrogen washout/washin technique in patients with acute respiratory distress syndrome.

Cyril Sargentini
  • Function : Author
  • PersonId : 917651
Fabiano Di Marco
  • Function : Author
  • PersonId : 917653
Alain Mercat
  • Function : Author
  • PersonId : 917654
Jean-Luc Diehl
  • Function : Author
  • PersonId : 917656
Jordi Mancebo
  • Function : Author
  • PersonId : 917657
Jean-Jacques Rouby
  • Function : Author
  • PersonId : 917658
Qin Lu
  • Function : Author
  • PersonId : 917659
Gilles Bernardin
  • Function : Author
  • PersonId : 893250
Laurent Brochard
  • Function : Author
  • PersonId : 910822

Abstract

ABSTRACT: INTRODUCTION: End-expiratory lung volume (EELV) is decreased in acute respiratory distress syndrome (ARDS), and bedside EELV measurement may help to set positive end-expiratory pressure (PEEP). Nitrogen washout/washin for EELV measurement is available at the bedside, but assessment of accuracy and precision in real life conditions are scant. Our purpose was to 1) assess EELV measurement precision in ARDS patients at two PEEP levels (three pairs of measurements), and 2) to compare the changes (Delta) induced by PEEP for total EELV with the PEEP-induced changes in lung volume above functional residual capacity measured by passive spirometry (DeltaPEEP-volume). The minimal predicted increase in lung volume was calculated from compliance at low PEEP and DeltaPEEP to ensure the validity of lung volume changes. METHODS: 34 patients with ARDS were prospectively included in five university-hospital intensive care units. DeltaEELV and DeltaPEEP-volume were compared between 6 and 15 cmH2O of PEEP. RESULTS: After exclusion of three patients, variability of the nitrogen technique was less than 4% and the largest difference between measurements was 81+/-64 ml. DeltaEELV and DeltaPEEP-volume were only weakly correlated (r2=0.47); 95% confidence interval limits -414 to 608 mL). In four patients with the highest PEEP ([greater than or equal to]16cmH2O), DeltaEELV was lower than the minimal predicted increase in lung volume, suggesting flawed measurements possibly due to leaks. Excluding those from the analysis markedly strengthened the correlation between DeltaEELV and DeltaPEEP-volume (r2=0.80). CONCLUSION: In most patients, the EELV technique has good reproducibility and accuracy even at high PEEP. At high pressuresit accuracy may be limited in case of leaks. The minimal predicted increase in lung volume may help to check for accuracy.
Fichier principal
Vignette du fichier
cc10587.pdf (388.38 Ko) Télécharger le fichier
cc10587.xml (63.77 Ko) Télécharger le fichier
Origin Publisher files allowed on an open archive
Format Other
Loading...

Dates and versions

inserm-00660290 , version 1 (16-01-2012)

Identifiers

Cite

Jean Dellamonica, Nicolas Lerolle, Cyril Sargentini, Gaetan Beduneau, Fabiano Di Marco, et al.. Accuracy and precision of end expiratory lung volume measurements by automated nitrogen washout/washin technique in patients with acute respiratory distress syndrome.. Critical Care, 2011, 15 (6), pp.R294. ⟨10.1186/cc10587⟩. ⟨inserm-00660290⟩
329 View
357 Download

Altmetric

Share

Gmail Mastodon Facebook X LinkedIn More