Skip Navigation

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (10)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by de Chazal, I.
Right arrow Articles by Hubmayr, R. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by de Chazal, I.
Right arrow Articles by Hubmayr, R. D.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

British Journal of Anaesthesia, 2003, Vol. 91, No. 1 81-91
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Review Article

Novel aspects of pulmonary mechanics in intensive care

I. de Chazal and R. D. Hubmayr*

Room 8-62 Stabile Building, Mayo Clinic, Rochester, MN 55905, USA

Corresponding author. E-mail: rhubmayr@mayo.edu

Keywords: intensive care; ventilation, mechanics

The first 150 words of the full text of this article appear below.

This review of the mechanical properties of the respiratory system is related to ventilator practice. As virtually all modern ventilators display traces of airway pressure (Paw), volume (V) and flow (V·) the necessary information is immediately available with no additional effort. This review interprets the information contained in ventilator waveforms. The review concentrates on three aspects where measurements are most useful, namely: (i) the diagnosis and management of patients with injured lungs; (iii) patients with airways obstruction; and (iii) the assessment of respiratory motor output. We will outline the precision and accuracy of the derived variables, discuss their scientific basis and review how decisions based on these measurements improve patient outcomes. We give a personal perspective even if it means taking sides in debates on controversial issues.

Basic principles

(For a full discussion of classic respiratory system mechanics the reader is referred to refs 6 and 47). Classic respiratory . . . [Full Text of this Article]

Assessment of respiratory mechanics in the diagnosis and management of patients with injured lungs

Injury mechanisms and their consequences on lung mechanics
Susceptibility of injured lungs to VILI
Whole respiratory system mechanics: methods and mechanistic interpretation
Role of respiratory mechanics testing in clinical decision-making
Assessment of respiratory mechanics in patients with airflow obstruction

Basic principles for identifying airway obstruction in a mechanically ventilated patient
The bedside diagnosis of obstruction in mechanically ventilated patients
Inadvertent PEEP
Inspection of expiratory flow–volume and flow-time tracings
Inspection of the Paw tracing (Fig. 5)
The peak Paw response to small step changes in PEEP (Fig. 6)
Clinical implications of respiratory mechanics measurements in patients with obstruction
Value of respiratory mechanics in the assessment of respiratory drive and timing

Acknowledgements


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
H. C. Yalcin, K. M. Hallow, J. Wang, M. T. Wei, H. D. Ou-Yang, and S. N. Ghadiali
Influence of cytoskeletal structure and mechanics on epithelial cell injury during cyclic airway reopening
Am J Physiol Lung Cell Mol Physiol, November 1, 2009; 297(5): L881 - L891.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
D. Talmor, T. Sarge, A. Malhotra, C. R. O'Donnell, R. Ritz, A. Lisbon, V. Novack, and S. H. Loring
Mechanical Ventilation Guided by Esophageal Pressure in Acute Lung Injury
N. Engl. J. Med., November 13, 2008; 359(20): 2095 - 2104.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. Talmor, T. Sarge, A. Legedza, C. R. O'Donnell, R. Ritz, S. H. Loring, and A. Malhotra
Cytokine Release Following Recruitment Maneuvers
Chest, November 1, 2007; 132(5): 1434 - 1439.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
F. Petak, W. Habre, B. Babik, J. Tolnai, and Z. Hantos
Crackle-sound recording to monitor airway closure and recruitment in ventilated pigs.
Eur. Respir. J., April 1, 2006; 27(4): 808 - 816.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
G. R. Washko, C. R. O'Donnell, and S. H. Loring
Volume-related and volume-independent effects of posture on esophageal and transpulmonary pressures in healthy subjects
J Appl Physiol, March 1, 2006; 100(3): 753 - 758.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
R. Baba, K. Paramesh, J. W. Zwaal, M. Griffiths, and E. Moloney
Protective ventilation of patients with acute respiratory distress syndrome
Br. J. Anaesth., July 1, 2004; 93(1): 153 - 153.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
D. Henzler, R. Rossaint, R. Kuhlen, J. Sprung, and D. L. Bourke
Is There a Need for a Recruiting Strategy in Morbidly Obese Patients Undergoing Laparoscopic Surgery? * Response
Anesth. Analg., January 1, 2004; 98(1): 268 - 269.
[Full Text] [PDF]