The Experts below are selected from a list of 27 Experts worldwide ranked by ideXlab platform

Xin-zhi Weng - One of the best experts on this subject based on the ideXlab platform.

  • The effects of extrinsic positive end-expiratory pressure on work of breathing in patients with chronic obstructive pulmonary disease
    Chinese Journal of Internal Medicine, 2001
    Co-Authors: Kong W, Chunxue Wang, Yuanhua Yang, Kewu Huang, Jiang C, Xin-zhi Weng
    Abstract:

    OBJECTIVE: To study the effect of extrinsic positive end-expiratory pressure(PEEPe) on work of breathing in chronic obstructive pulmonary disease (COPD) patients and its mechanism. METHODS: 10 ventilated patients [4 males and 6 females with mean age of (70.1 +/- 5.5) years] with exacerbation of COPD were admitted into the study. All the patients' cardiopulmonary functions were stable, and they could receive pressure support ventilation (PSV). Patients with sever heart dysfunction, hepatic dysfunction, renal dysfunction or fever were ruled out. Each patient had an Esophagus Balloon pressure sensor inserted, and the Esophagus Balloon was properly positioned using "occlusion test". Flow sensor was placed at the end of tracheal tube opening. Then Esophagus Balloon pressure sensor and flow sensor were connected with Bicore CP-100 pulmonary monitor. Dynamic intrinsic positive end-expiratory pressure (PEEPi, dyn), difference of Esophagus pressure (dPes), work of breathing patient (WOBp), work of breathing ventilator (WOBv), pressure time product (PTP), tidal volume (Vt), respiratory rate (RR), minute ventilation (MV), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), expiratory airway resistance (Rawe), fraction of inspiration (Ti/Ttot) and so on were measured. PEEPi,dyn was measured by Esophagus Balloon technique. Electrocardiogram and noninvasive blood pressure modes were added to HP M1165A monitor. Heart rate (HR) and blood pressure (BP) were also measured. Arterial blood was analyzed to measure pH, partial pressure of oxygen in arterial blood (PaO(2)), partial pressure of carbon dioxide in arterial blood (PaCO(2)) and saturation of arterial blood oxygen (SaO(2)). At first, PEEPi, dyn was measured when PEEPe was zero, which was called PEEPi, dynz and was set as baseline. Then PEEPe was set randomly, which was 0%, 40%, 60%, 80% and 100% of PEEPi, dynz respectively. Other parameters remained stable. All the indexes were measured 30 minutes after the level of PEEPe was changed. RESULTS: WOBp decreased as PEEPe increased, from (1.08 +/- 0.49) J/L of PEEPe-0% of PEEPi,dynz to (0.57 +/- 0.32) J/L of PEEPe-100% of PEEPi, dynz, and significant difference was found between each level of PEEPe and the baseline (P < 0.01). But we didn't find significant difference between PEEPe-80% of PEEPi,dynz and PEEPe-100% of PEEPi, dynz. WOBv increased significantly as PEEPe increased, from (1.50 +/- 0.47) J/L of PEEPe-0% of PEEPi, dynz to (1.82 +/- 0.56) J/L of PEEPe-80% of PEEPi, dynz and (1.85 +/- 0.48) J/L of PEEPe-100% of PEEPi,dynz(P < 0.01). The total WOB (WOBp + WOBv) remained steady. PTP trended to decrease, from (153.6 +/- 76.8) cm H(2)O x s x m(-1) of PEEPe-0% of PEEPi, dynz to (86.9 +/- 45.9) cm H(2)O x s x m(-1) of PEEPe-100% of PEEPi, dynz; the difference of PTP between PEEPe-40% of PEEPi,dynz and PEEPe-0% of PEEPi, dynz was significant(P < 0.05), the differences between other levels of PEEPe and PEEPe-0% of PEEPi, dynz were very significant (P < 0.01), but no significant difference was found between PEEPe-80% of PEEPi, dynz and PEEPe-100% of PEEPi, dynz. PEEPi,dyn also decreased significantly as PEEPe increased, from (7.70 +/- 1.42) cm H(2)O of PEEPe-0% of PEEPi, dynz to (2.10 +/- 0.57) cm H(2)O of PEEPe-100% of PEEPi, dynz, very significant differences were found between each level of PEEPe and the baseline (P < 0.01). Significant positive linear correlation was found between DeltaWOBp and DeltaPEEPi, dyn were(r = 0.609, P < 0.01, n = 10). dPes decreased as PEEPe increased, from (15.20 +/- 4.16) cm H(2)O of PEEPe-0% of PEEPi, dynz to (8.20 +/- 4.13) cm H(2)O of PEEPe-100% of PEEPi, dynz, and very significant differences were found between each level of PEEPe and the baseline (P < 0.01). But the difference between PEEPe-80% of PEEPi, dynz and PEEPe-100% of PEEPi, dynz wasn't significant, even dPes of PEEPe-100% of PEEPi, dynz was higher than that of PEEPe-80% of PEEPi, dynz. Vt didn't change markedly. RR, MV and f/Vt increased slightly. Both PIFR and PEFR didn't change markedly. At the same time, HR, BP and blood gas analysis were investigated, but no significant change was found. CONCLUSION: PEEPe can reduce WOBp significantly and improve the coordination between the patient and ventilator. It is shown that decrement of pressure difference between alveolar and central airway leads to decrement of WOBp.

Zhou Yi - One of the best experts on this subject based on the ideXlab platform.

  • Proper extrinsic positive end-expiratory pressure during mechanical ventilation in patients with chronic obstructive pulmonary disease
    Shanghai Medical Journal, 2020
    Co-Authors: Zhou Yi
    Abstract:

    Objective To discuss the proper range of extrinsic positive end-expiratory pressure (PEEPe) during mechanical ventilation in patients with chronic obstructive pulmonary disease (COPD). Methods Thirty-six ventilated patients with confirmed COPD were included in the present study. Dynamic intrinsic positive end-expiratory pressure (PEEPi),work of breathing patient (WOBp),work of breathing ventilation (WOBv),difference of Esophagus pressure (dPes),tidal volume (Vt),peak pressure (Ppeak),plateau pressure (Pplat),and respiratory system compliance (Crs) were measured by Esophagus Balloon pressure sensor and flow sensor. Heart rate (HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),cardiac output(CO),and cardiac index (CI) were measured by GE Solar 8000 monitor. All above measurements were repeated with PEEPe set at 0,40%,50%,60%,70%,80%,90% and 100% of PEEPi. Results WOBp decreased as PEEPe increased,and the difference between PEEPe at 60% of PEEPi and baseline was significantly different (all P0.05). The dPes decreased as PEEPe increased,and the difference between PEEPe at 70% of PEEPi and baseline was significant (all P0.05). Ppeak and Pplat increased with the increase of PEEPe,and significant difference was found between PEEPe at 60% of PEEPi and baseline (all P0.05); besides,the difference between PEEPe at 60% of PEEPi and PEEPe at 100% of PEEPi was also significant (P0.05). When PEEPe increased,CO and CI decreased continuously,and there was significant difference between PEEPe at 90% of PEEPi and baseline (both P0.05). Conclusion PEEPe at 60%-80% of PEEPi can reduce WOBp and improve Crs. PEEPe at this level has little inhibition on circulation and is the optimal PEEPe for patients with COPD.

Kong W - One of the best experts on this subject based on the ideXlab platform.

  • The effects of extrinsic positive end-expiratory pressure on work of breathing in patients with chronic obstructive pulmonary disease
    Chinese Journal of Internal Medicine, 2001
    Co-Authors: Kong W, Chunxue Wang, Yuanhua Yang, Kewu Huang, Jiang C, Xin-zhi Weng
    Abstract:

    OBJECTIVE: To study the effect of extrinsic positive end-expiratory pressure(PEEPe) on work of breathing in chronic obstructive pulmonary disease (COPD) patients and its mechanism. METHODS: 10 ventilated patients [4 males and 6 females with mean age of (70.1 +/- 5.5) years] with exacerbation of COPD were admitted into the study. All the patients' cardiopulmonary functions were stable, and they could receive pressure support ventilation (PSV). Patients with sever heart dysfunction, hepatic dysfunction, renal dysfunction or fever were ruled out. Each patient had an Esophagus Balloon pressure sensor inserted, and the Esophagus Balloon was properly positioned using "occlusion test". Flow sensor was placed at the end of tracheal tube opening. Then Esophagus Balloon pressure sensor and flow sensor were connected with Bicore CP-100 pulmonary monitor. Dynamic intrinsic positive end-expiratory pressure (PEEPi, dyn), difference of Esophagus pressure (dPes), work of breathing patient (WOBp), work of breathing ventilator (WOBv), pressure time product (PTP), tidal volume (Vt), respiratory rate (RR), minute ventilation (MV), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), expiratory airway resistance (Rawe), fraction of inspiration (Ti/Ttot) and so on were measured. PEEPi,dyn was measured by Esophagus Balloon technique. Electrocardiogram and noninvasive blood pressure modes were added to HP M1165A monitor. Heart rate (HR) and blood pressure (BP) were also measured. Arterial blood was analyzed to measure pH, partial pressure of oxygen in arterial blood (PaO(2)), partial pressure of carbon dioxide in arterial blood (PaCO(2)) and saturation of arterial blood oxygen (SaO(2)). At first, PEEPi, dyn was measured when PEEPe was zero, which was called PEEPi, dynz and was set as baseline. Then PEEPe was set randomly, which was 0%, 40%, 60%, 80% and 100% of PEEPi, dynz respectively. Other parameters remained stable. All the indexes were measured 30 minutes after the level of PEEPe was changed. RESULTS: WOBp decreased as PEEPe increased, from (1.08 +/- 0.49) J/L of PEEPe-0% of PEEPi,dynz to (0.57 +/- 0.32) J/L of PEEPe-100% of PEEPi, dynz, and significant difference was found between each level of PEEPe and the baseline (P < 0.01). But we didn't find significant difference between PEEPe-80% of PEEPi,dynz and PEEPe-100% of PEEPi, dynz. WOBv increased significantly as PEEPe increased, from (1.50 +/- 0.47) J/L of PEEPe-0% of PEEPi, dynz to (1.82 +/- 0.56) J/L of PEEPe-80% of PEEPi, dynz and (1.85 +/- 0.48) J/L of PEEPe-100% of PEEPi,dynz(P < 0.01). The total WOB (WOBp + WOBv) remained steady. PTP trended to decrease, from (153.6 +/- 76.8) cm H(2)O x s x m(-1) of PEEPe-0% of PEEPi, dynz to (86.9 +/- 45.9) cm H(2)O x s x m(-1) of PEEPe-100% of PEEPi, dynz; the difference of PTP between PEEPe-40% of PEEPi,dynz and PEEPe-0% of PEEPi, dynz was significant(P < 0.05), the differences between other levels of PEEPe and PEEPe-0% of PEEPi, dynz were very significant (P < 0.01), but no significant difference was found between PEEPe-80% of PEEPi, dynz and PEEPe-100% of PEEPi, dynz. PEEPi,dyn also decreased significantly as PEEPe increased, from (7.70 +/- 1.42) cm H(2)O of PEEPe-0% of PEEPi, dynz to (2.10 +/- 0.57) cm H(2)O of PEEPe-100% of PEEPi, dynz, very significant differences were found between each level of PEEPe and the baseline (P < 0.01). Significant positive linear correlation was found between DeltaWOBp and DeltaPEEPi, dyn were(r = 0.609, P < 0.01, n = 10). dPes decreased as PEEPe increased, from (15.20 +/- 4.16) cm H(2)O of PEEPe-0% of PEEPi, dynz to (8.20 +/- 4.13) cm H(2)O of PEEPe-100% of PEEPi, dynz, and very significant differences were found between each level of PEEPe and the baseline (P < 0.01). But the difference between PEEPe-80% of PEEPi, dynz and PEEPe-100% of PEEPi, dynz wasn't significant, even dPes of PEEPe-100% of PEEPi, dynz was higher than that of PEEPe-80% of PEEPi, dynz. Vt didn't change markedly. RR, MV and f/Vt increased slightly. Both PIFR and PEFR didn't change markedly. At the same time, HR, BP and blood gas analysis were investigated, but no significant change was found. CONCLUSION: PEEPe can reduce WOBp significantly and improve the coordination between the patient and ventilator. It is shown that decrement of pressure difference between alveolar and central airway leads to decrement of WOBp.

Chunxue Wang - One of the best experts on this subject based on the ideXlab platform.

  • The effects of extrinsic positive end-expiratory pressure on work of breathing in patients with chronic obstructive pulmonary disease
    Chinese Journal of Internal Medicine, 2001
    Co-Authors: Kong W, Chunxue Wang, Yuanhua Yang, Kewu Huang, Jiang C, Xin-zhi Weng
    Abstract:

    OBJECTIVE: To study the effect of extrinsic positive end-expiratory pressure(PEEPe) on work of breathing in chronic obstructive pulmonary disease (COPD) patients and its mechanism. METHODS: 10 ventilated patients [4 males and 6 females with mean age of (70.1 +/- 5.5) years] with exacerbation of COPD were admitted into the study. All the patients' cardiopulmonary functions were stable, and they could receive pressure support ventilation (PSV). Patients with sever heart dysfunction, hepatic dysfunction, renal dysfunction or fever were ruled out. Each patient had an Esophagus Balloon pressure sensor inserted, and the Esophagus Balloon was properly positioned using "occlusion test". Flow sensor was placed at the end of tracheal tube opening. Then Esophagus Balloon pressure sensor and flow sensor were connected with Bicore CP-100 pulmonary monitor. Dynamic intrinsic positive end-expiratory pressure (PEEPi, dyn), difference of Esophagus pressure (dPes), work of breathing patient (WOBp), work of breathing ventilator (WOBv), pressure time product (PTP), tidal volume (Vt), respiratory rate (RR), minute ventilation (MV), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), expiratory airway resistance (Rawe), fraction of inspiration (Ti/Ttot) and so on were measured. PEEPi,dyn was measured by Esophagus Balloon technique. Electrocardiogram and noninvasive blood pressure modes were added to HP M1165A monitor. Heart rate (HR) and blood pressure (BP) were also measured. Arterial blood was analyzed to measure pH, partial pressure of oxygen in arterial blood (PaO(2)), partial pressure of carbon dioxide in arterial blood (PaCO(2)) and saturation of arterial blood oxygen (SaO(2)). At first, PEEPi, dyn was measured when PEEPe was zero, which was called PEEPi, dynz and was set as baseline. Then PEEPe was set randomly, which was 0%, 40%, 60%, 80% and 100% of PEEPi, dynz respectively. Other parameters remained stable. All the indexes were measured 30 minutes after the level of PEEPe was changed. RESULTS: WOBp decreased as PEEPe increased, from (1.08 +/- 0.49) J/L of PEEPe-0% of PEEPi,dynz to (0.57 +/- 0.32) J/L of PEEPe-100% of PEEPi, dynz, and significant difference was found between each level of PEEPe and the baseline (P < 0.01). But we didn't find significant difference between PEEPe-80% of PEEPi,dynz and PEEPe-100% of PEEPi, dynz. WOBv increased significantly as PEEPe increased, from (1.50 +/- 0.47) J/L of PEEPe-0% of PEEPi, dynz to (1.82 +/- 0.56) J/L of PEEPe-80% of PEEPi, dynz and (1.85 +/- 0.48) J/L of PEEPe-100% of PEEPi,dynz(P < 0.01). The total WOB (WOBp + WOBv) remained steady. PTP trended to decrease, from (153.6 +/- 76.8) cm H(2)O x s x m(-1) of PEEPe-0% of PEEPi, dynz to (86.9 +/- 45.9) cm H(2)O x s x m(-1) of PEEPe-100% of PEEPi, dynz; the difference of PTP between PEEPe-40% of PEEPi,dynz and PEEPe-0% of PEEPi, dynz was significant(P < 0.05), the differences between other levels of PEEPe and PEEPe-0% of PEEPi, dynz were very significant (P < 0.01), but no significant difference was found between PEEPe-80% of PEEPi, dynz and PEEPe-100% of PEEPi, dynz. PEEPi,dyn also decreased significantly as PEEPe increased, from (7.70 +/- 1.42) cm H(2)O of PEEPe-0% of PEEPi, dynz to (2.10 +/- 0.57) cm H(2)O of PEEPe-100% of PEEPi, dynz, very significant differences were found between each level of PEEPe and the baseline (P < 0.01). Significant positive linear correlation was found between DeltaWOBp and DeltaPEEPi, dyn were(r = 0.609, P < 0.01, n = 10). dPes decreased as PEEPe increased, from (15.20 +/- 4.16) cm H(2)O of PEEPe-0% of PEEPi, dynz to (8.20 +/- 4.13) cm H(2)O of PEEPe-100% of PEEPi, dynz, and very significant differences were found between each level of PEEPe and the baseline (P < 0.01). But the difference between PEEPe-80% of PEEPi, dynz and PEEPe-100% of PEEPi, dynz wasn't significant, even dPes of PEEPe-100% of PEEPi, dynz was higher than that of PEEPe-80% of PEEPi, dynz. Vt didn't change markedly. RR, MV and f/Vt increased slightly. Both PIFR and PEFR didn't change markedly. At the same time, HR, BP and blood gas analysis were investigated, but no significant change was found. CONCLUSION: PEEPe can reduce WOBp significantly and improve the coordination between the patient and ventilator. It is shown that decrement of pressure difference between alveolar and central airway leads to decrement of WOBp.

Yuanhua Yang - One of the best experts on this subject based on the ideXlab platform.

  • The effects of extrinsic positive end-expiratory pressure on work of breathing in patients with chronic obstructive pulmonary disease
    Chinese Journal of Internal Medicine, 2001
    Co-Authors: Kong W, Chunxue Wang, Yuanhua Yang, Kewu Huang, Jiang C, Xin-zhi Weng
    Abstract:

    OBJECTIVE: To study the effect of extrinsic positive end-expiratory pressure(PEEPe) on work of breathing in chronic obstructive pulmonary disease (COPD) patients and its mechanism. METHODS: 10 ventilated patients [4 males and 6 females with mean age of (70.1 +/- 5.5) years] with exacerbation of COPD were admitted into the study. All the patients' cardiopulmonary functions were stable, and they could receive pressure support ventilation (PSV). Patients with sever heart dysfunction, hepatic dysfunction, renal dysfunction or fever were ruled out. Each patient had an Esophagus Balloon pressure sensor inserted, and the Esophagus Balloon was properly positioned using "occlusion test". Flow sensor was placed at the end of tracheal tube opening. Then Esophagus Balloon pressure sensor and flow sensor were connected with Bicore CP-100 pulmonary monitor. Dynamic intrinsic positive end-expiratory pressure (PEEPi, dyn), difference of Esophagus pressure (dPes), work of breathing patient (WOBp), work of breathing ventilator (WOBv), pressure time product (PTP), tidal volume (Vt), respiratory rate (RR), minute ventilation (MV), peak inspiratory flow rate (PIFR), peak expiratory flow rate (PEFR), expiratory airway resistance (Rawe), fraction of inspiration (Ti/Ttot) and so on were measured. PEEPi,dyn was measured by Esophagus Balloon technique. Electrocardiogram and noninvasive blood pressure modes were added to HP M1165A monitor. Heart rate (HR) and blood pressure (BP) were also measured. Arterial blood was analyzed to measure pH, partial pressure of oxygen in arterial blood (PaO(2)), partial pressure of carbon dioxide in arterial blood (PaCO(2)) and saturation of arterial blood oxygen (SaO(2)). At first, PEEPi, dyn was measured when PEEPe was zero, which was called PEEPi, dynz and was set as baseline. Then PEEPe was set randomly, which was 0%, 40%, 60%, 80% and 100% of PEEPi, dynz respectively. Other parameters remained stable. All the indexes were measured 30 minutes after the level of PEEPe was changed. RESULTS: WOBp decreased as PEEPe increased, from (1.08 +/- 0.49) J/L of PEEPe-0% of PEEPi,dynz to (0.57 +/- 0.32) J/L of PEEPe-100% of PEEPi, dynz, and significant difference was found between each level of PEEPe and the baseline (P < 0.01). But we didn't find significant difference between PEEPe-80% of PEEPi,dynz and PEEPe-100% of PEEPi, dynz. WOBv increased significantly as PEEPe increased, from (1.50 +/- 0.47) J/L of PEEPe-0% of PEEPi, dynz to (1.82 +/- 0.56) J/L of PEEPe-80% of PEEPi, dynz and (1.85 +/- 0.48) J/L of PEEPe-100% of PEEPi,dynz(P < 0.01). The total WOB (WOBp + WOBv) remained steady. PTP trended to decrease, from (153.6 +/- 76.8) cm H(2)O x s x m(-1) of PEEPe-0% of PEEPi, dynz to (86.9 +/- 45.9) cm H(2)O x s x m(-1) of PEEPe-100% of PEEPi, dynz; the difference of PTP between PEEPe-40% of PEEPi,dynz and PEEPe-0% of PEEPi, dynz was significant(P < 0.05), the differences between other levels of PEEPe and PEEPe-0% of PEEPi, dynz were very significant (P < 0.01), but no significant difference was found between PEEPe-80% of PEEPi, dynz and PEEPe-100% of PEEPi, dynz. PEEPi,dyn also decreased significantly as PEEPe increased, from (7.70 +/- 1.42) cm H(2)O of PEEPe-0% of PEEPi, dynz to (2.10 +/- 0.57) cm H(2)O of PEEPe-100% of PEEPi, dynz, very significant differences were found between each level of PEEPe and the baseline (P < 0.01). Significant positive linear correlation was found between DeltaWOBp and DeltaPEEPi, dyn were(r = 0.609, P < 0.01, n = 10). dPes decreased as PEEPe increased, from (15.20 +/- 4.16) cm H(2)O of PEEPe-0% of PEEPi, dynz to (8.20 +/- 4.13) cm H(2)O of PEEPe-100% of PEEPi, dynz, and very significant differences were found between each level of PEEPe and the baseline (P < 0.01). But the difference between PEEPe-80% of PEEPi, dynz and PEEPe-100% of PEEPi, dynz wasn't significant, even dPes of PEEPe-100% of PEEPi, dynz was higher than that of PEEPe-80% of PEEPi, dynz. Vt didn't change markedly. RR, MV and f/Vt increased slightly. Both PIFR and PEFR didn't change markedly. At the same time, HR, BP and blood gas analysis were investigated, but no significant change was found. CONCLUSION: PEEPe can reduce WOBp significantly and improve the coordination between the patient and ventilator. It is shown that decrement of pressure difference between alveolar and central airway leads to decrement of WOBp.