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Paulo Tavares - One of the best experts on this subject based on the ideXlab platform.

  • evaluation of Peak Inspiratory Pressure and respiratory rate during ventilation of an infant lung model with a self inflating bag
    Jornal De Pediatria, 2006
    Co-Authors: Jefferson G Resende, Carlos A M Zaconeta, Antonio C P Ferreira, Cesar Augusto Melo E Silva, Marcelo Palmeira Rodrigues, Cristiane G Menezes, Ana Paula, Paulo Tavares
    Abstract:

    Abstract Objective: To evaluate the Peak Inspiratory Pressure and ventilation rate achieved by physicians when usinga neonatal self-inflating bag on a lung model.Methods: Fifteen physicians ventilated full term and preterm infant lung simulators while the outcomes werecaptured by a ventilation monitor.Results: Median Peak Pressures in cmH 2 O for full term and preterm lungs were 23 (interquartile range: 15-47)and 26 (interquartile range: 14-51), being less than 20 in 41.2 and 35.8% of the Pressure curves analyzed, morethan 40 in 29.7 and 33.6%, and between 27 and 33 cmH 2 O in 8.2 and 6.5% of the curves, respectively. Medianventilation rates were 45 (interquartile range: 36-57) and 48 (interquartile range: 39-55.5) cycles per minute, beingmore than 30 in 9.3 and 6.7% of Pressure curves and more than 60 in 12 and 13.3% of Pressure curves, for thefull term and preterm lungs, respectively. The differences between these medians were not statistically significant.Conclusions: Ventilation rates achieved with the self-inflating bag were adequate in approximately 80% ofPressure curves analyzed, but the physicians were unable to provide ventilation with minimal Pressure variation,producing Pressures that diverged from those defined by the neonatal resuscitation training course in 70% of thecurves. This was irrespective of whether they were ventilating the lung model analogous to preterm or full term infantlungs.J Pediatr (Rio J). 2006;82(5):359-64: Cardiopulmonary resuscitation, pulmonary ventilation, mechanicalventilation artificial respiration, newborn infant, neonatal asphyxia.

  • evaluation of Peak Inspiratory Pressure tidal volume and respiratory rate during ventilation of premature lambs using a self inflating bag
    Jornal De Pediatria, 2006
    Co-Authors: Jefferson G Resende, Carlos A M Zaconeta, Antonio C P Ferreira, Cesar Augusto Melo E Silva, Marcelo Palmeira Rodrigues, Celso Moura Rebello, Paulo Tavares
    Abstract:

    OBJECTIVE: To evaluate the Peak Inspiratory Pressure, tidal volume and respiratory rate achieved during manual ventilation of premature lambs, using a self-inflating bag. METHODS: In this descriptive, experimental study, five pairs of physicians, selected at random among 35 neonatologists working at a neonatal intensive care unit and with experience in the resuscitation of newborn infants, ventilated five intubated premature lambs using a self-inflating bag. Pressure and flow monitor signals were passed through a transducer and digitized for recording and analysis. Tidal volume and Pressure curves were obtained from the integral of flow rate, at Peak, during the last 50 seconds of every fifth minute, and analyzed. RESULTS: Median Pressure was 39.8 (IQ25-75% 30.2-47.2) cmH2O; being below 20 in 1.1% of cases and above 40 in 49.1%. Seven out of 10 physicians produced more than six Pressure Peaks of over 40 cmH2O. Median tidal volume/kg was 17.8 (IQ25-75% 14.1-22.4) mL, being below 5 mL in 0.1% of cases and greater than or equal to 20 mL in 37.7%. All of the physicians propelled five or more ventilation cycles with tidal volume/kg of 20 mL or more. Respiratory rate was between 30 and 60 cycles/minute in 65.9% of cases, being below 30 in 6.8% of cases and over 60 in 27.3% of cases. CONCLUSIONS: There was major variation in Peak Inspiratory Pressure and tidal volume/kg values, which were in many cases elevated, attaining levels that habitually cause biotrauma, while respiratory rates were adequate in the majority of cases.

  • evaluation of Peak Inspiratory Pressure tidal volume and respiratory rate during ventilation of premature lambs using a self inflating bag avaliaaao do pico de pressao do volume corrente e da freq œncia respiraturia durante ventilaaao de carneiros pr
    2006
    Co-Authors: Jefferson G Resende, Carlos A M Zaconeta, Antonio C P Ferreira, Marcelo Palmeira Rodrigues, Celso Moura Rebello, Aniceto Silva, Paulo Tavares
    Abstract:

    Objective: To evaluate the Peak Inspiratory Pressure, tidal volume and respiratory rate achieved during manual ventilation of premature lambs, using a self-inflating bag. Methods: In this descriptive, experimental study, five pairs of physicians, selected at random among 35 neonatologists working at a neonatal intensive care unit and with experience in the resuscitation of newborn infants, ventilated five intubated premature lambs using a self-inflating bag. Pressure and flow monitor signals were passed through a transducer and digitized for recording and analysis. Tidal volume and Pressure curves were obtained from the integral of flow rate, at Peak, during the last 50 seconds of every fifth minute, and analyzed.

  • evaluation of Peak Inspiratory Pressure and respiratory rate during ventilation of an infant lung model with a self inflating bag avaliaaao do pico de pressao e da freq œncia respiraturia durante o uso de balao auto inflaevel em um modelo de pulmao n
    2006
    Co-Authors: Jefferson G Resende, Carlos A M Zaconeta, Antonio C P Ferreira, Marcelo Palmeira Rodrigues, Cristiane G Menezes, Ana Paula, Aniceto Silva, Paulo Tavares
    Abstract:

    Objective: To evaluate the Peak Inspiratory Pressure and ventilation rate achieved by physicians when using a neonatal self-inflating bag on a lung model. Methods: Fifteen physicians ventilated full term and preterm infant lung simulators while the outcomes were captured by a ventilation monitor. Results: Median Peak Pressures in cmH2O for full term and preterm lungs were 23 (interquartile range: 15-47) and 26 (interquartile range: 14-51), being less than 20 in 41.2 and 35.8% of the Pressure curves analyzed, more than 40 in 29.7 and 33.6%, and between 27 and 33 cmH2O in 8.2 and 6.5% of the curves, respectively. Median ventilation rates were 45 (interquartile range: 36-57) and 48 (interquartile range: 39-55.5) cycles per minute, being more than 30 in 9.3 and 6.7% of Pressure curves and more than 60 in 12 and 13.3% of Pressure curves, for the full term and preterm lungs, respectively. The differences between these medians were not statistically significant. Conclusions: Ventilation rates achieved with the self-inflating bag were adequate in approximately 80% of Pressure curves analyzed, but the physicians were unable to provide ventilation with minimal Pressure variation, producing Pressures that diverged from those defined by the neonatal resuscitation training course in 70% of the curves. This was irrespective of whether they were ventilating the lung model analogous to preterm or full term infant lungs.

Eduardo Mello De Capitani - One of the best experts on this subject based on the ideXlab platform.

  • alterations in Peak Inspiratory Pressure and tidal volume delivered by manually operated self inflating resuscitation bags as a function of the oxygen supply rate
    Jornal Brasileiro De Pneumologia, 2008
    Co-Authors: Armando Carlos Franco De Godoy, Ronan Jose Vieira, Eduardo Mello De Capitani
    Abstract:

    OBJECTIVE: To assess possible alterations in the tidal volume and Peak Inspiratory Pressure delivered by seven models of manually operated self-inflating resuscitation bags as a function of the oxygen supply rate used. METHODS: The resuscitation bags tested were the following: Oxigel, models A and B; CE Reanimadores; ProtecSolutions; Missouri; Axmed; and Narcosul. For the measurements, a wall oxygen flow meter, a flow meter/respirometer, a resuscitation bag, a sensor (Tracer 5 unit), and a test lung were connected. In addition, the Tracer 5 unit was connected to a notebook computer. Oxygen supply rates of 1, 5, 10, and 15 L/min were used. RESULTS: The tidal volume delivered by the Oxigel model A resuscitation bag when receiving oxygen at a rate of 15 L/min was approximately 99% greater than that delivered when receiving oxygen at a rate of 1 L/min. Similarly, Peak Inspiratory Pressure was approximately 155% greater. Under the same conditions, the tidal volume delivered by the Narcosul resuscitation bag was 48% greater, and Peak Inspiratory Pressure was 105% greater. The remaining resuscitation bags tested showed no significant alterations in the tidal volume or Peak Inspiratory Pressure delivered. CONCLUSIONS: Under the resistance and compliance conditions used, the resuscitation bags in which the oxygen inflow is directly to the interior of the bag had the patient valve stuck at the Inspiratory position when receiving oxygen at a rate > 5 L/min, significantly increasing the tidal volume and Peak Inspiratory Pressure delivered. This did not occur with the resuscitation bags in which the oxygen inflow is directed to the exterior of the bag.

  • alterations in Peak Inspiratory Pressure and tidal volume delivered by manually operated self inflating resuscitation bags as a function of the oxygen supply rate alteracoes da pressao de pico inspiratorio e do volume corrente fornecidos por reanimad
    Scopus, 2008
    Co-Authors: De Godoy A C F, Ronan Jose Vieira, Eduardo Mello De Capitani
    Abstract:

    Objective: To assess possible alterations in the tidal volume and Peak Inspiratory Pressure delivered by seven models of manually operated self-inflating resuscitation bags as a function of the oxygen supply rate used. Methods: The resuscitation bags tested were the following: Oxigel, models A and B; CE Reanimadores; ProtecSolutions; Missouri; Axmed; and Narcosul. For the measurements, a wall oxygen flow meter, a flow meter/respirometer, a resuscitation bag, a sensor (Tracer 5 unit), and a test lung were connected. In addition, the Tracer 5 unit was connected to a notebook computer. Oxygen supply rates of 1, 5, 10, and 15 L/min were used. Results: The tidal volume delivered by the Oxigel model A resuscitation bag when receiving oxygen at a rate of 15 L/min was approximately 99% greater than that delivered when receiving oxygen at a rate of 1 L/min. Similarly, Peak Inspiratory Pressure was approximately 155% greater. Under the same conditions, the tidal volume delivered by the Narcosul resuscitation bag was 48% greater, and Peak Inspiratory Pressure was 105% greater. The remaining resuscitation bags tested showed no significant alterations in the tidal volume or Peak Inspiratory Pressure delivered. Conclusions: Under the resistance and compliance conditions used, the resuscitation bags in which the oxygen inflow is directed to the interior of the bag had the patient valve stuck at the Inspiratory position when receiving oxygen at a rate ≥ 5 L/min, significantly increasing the tidal volume and Peak Inspiratory Pressure delivered. This did not occur with the resuscitation bags in which the oxygen inflow is directed to the exterior of the bag.

  • artigo original alteracoes da pressao de pico inspiratorio e do volume corrente fornecidos por reanimadores manuais com balao auto inflavel em funcao do fluxo de entrada de oxigenio utilizado alterations in Peak Inspiratory Pressure and tidal volume
    2008
    Co-Authors: Armando Carlos, Ronan Jose Vieira, Franco De Godoy, Eduardo Mello De Capitani
    Abstract:

    Objective: To assess possible alterations in the tidal volume and Peak Inspiratory Pressure delivered by seven models of manually operated self-inflating resuscitation bags as a function of the oxygen supply rate used. Methods: The resuscitation bags tested were the following: Oxigel, models A and B; CE Reanimadores; ProtecSolutions; Missouri; Axmed; and Narcosul. For the measurements, a wall oxygen flow meter, a flow meter/respirometer, a resuscitation bag, a sensor (Tracer 5 unit), and a test lung were connected. In addition, the Tracer 5 unit was connected to a notebook computer. Oxygen supply rates of 1, 5, 10, and 15 L/min were used. Results: The tidal volume delivered by the Oxigel model A resuscitation bag when receiving oxygen at a rate of 15 L/min was approximately 99% greater than that delivered when receiving oxygen at a rate of 1 L/min. Similarly, Peak Inspiratory Pressure was approximately 155% greater. Under the same conditions, the tidal volume delivered by the Narcosul resuscitation bag was 48% greater, and Peak Inspiratory Pressure was 105% greater. The remaining resuscitation bags tested showed no significant alterations in the tidal volume or Peak Inspiratory Pressure delivered. Conclusions: Under the resistance and compliance conditions used, the resuscitation bags in which the oxygen inflow is directly to the interior of the bag had the patient valve stuck at the Inspiratory position when receiving oxygen at a rate ≥ 5 L/min, significantly increasing the tidal volume and Peak Inspiratory Pressure delivered. This did not occur with the resuscitation bags in which the oxygen inflow is directed to the exterior of the bag.

Berno Misgeld - One of the best experts on this subject based on the ideXlab platform.

  • CDC - Periodic funnel-based control for Peak Inspiratory Pressure
    2015 54th IEEE Conference on Decision and Control (CDC), 2015
    Co-Authors: Anake Pomprapa, Sören Weyer, Steffen Leonhardt, Marian Walter, Berno Misgeld
    Abstract:

    Intensive care unit patients generally require a mechanical ventilator with the aim to improve gas exchange. Hereby, the quality of artificial ventilation significantly depends on the mechanical ventilator in terms of its stability, accuracy and transient response. In this article, we demonstrate a non-identifier based control algorithm, called funnel-based control of Peak Inspiratory Pressure (PIP). In Pressure-controlled ventilation based on our tailor-made mechanical ventilation system, PIP can be periodically regulated to the pre-defined target reference value using an output feedback structure, so that airway Pressure can be delivered into the front-end respiratory system. The goal of the control system is to guarantee a fast response with minimal steady state error on a breath-by-breath basis and to suppress the overshooting of the response, in order to avoid alveoli overinflation and possible lung injury. The control performance is assessed with distinctive results from a number of experiments with a plastic lung, based on the hyperbolic and exponential funnel performance boundaries.

  • Periodic funnel-based control for Peak Inspiratory Pressure
    2015 54th IEEE Conference on Decision and Control (CDC), 2015
    Co-Authors: Anake Pomprapa, Sören Weyer, Steffen Leonhardt, Marian Walter, Berno Misgeld
    Abstract:

    Intensive care unit patients generally require a mechanical ventilator with the aim to improve gas exchange. Hereby, the quality of artificial ventilation significantly depends on the mechanical ventilator in terms of its stability, accuracy and transient response. In this article, we demonstrate a non-identifier based control algorithm, called funnel-based control of Peak Inspiratory Pressure (PIP). In Pressure-controlled ventilation based on our tailor-made mechanical ventilation system, PIP can be periodically regulated to the pre-defined target reference value using an output feedback structure, so that airway Pressure can be delivered into the front-end respiratory system. The goal of the control system is to guarantee a fast response with minimal steady state error on a breath-by-breath basis and to suppress the overshooting of the response, in order to avoid alveoli overinflation and possible lung injury. The control performance is assessed with distinctive results from a number of experiments with a plastic lung, based on the hyperbolic and exponential funnel performance boundaries.

B D Schouten - One of the best experts on this subject based on the ideXlab platform.

  • evaluation of a ventilation strategy to prevent barotrauma in patients at high risk for acute respiratory distress syndrome
    The New England Journal of Medicine, 1998
    Co-Authors: Thomas E Stewart, Maureen O Meade, Deborah J Cook, John Granton, Rick Hodder, Stephen E Lapinsky, C D Mazer, Richard F Mclean, T S Rogovein, B D Schouten
    Abstract:

    Background A strategy of mechanical ventilation that limits airway Pressure and tidal volume while permitting hypercapnia has been recommended for patients with the acute respiratory distress syndrome. The goal is to reduce lung injury due to overdistention. However, the efficacy of this approach has not been established. Methods Within 24 hours of intubation, patients at high risk for the acute respiratory distress syndrome were randomly assigned to either Pressure- and volume-limited ventilation (limited-ventilation group), with the Peak Inspiratory Pressure maintained at 30 cm of water or less and the tidal volume at 8 ml per kilogram of body weight or less, or to conventional ventilation (control group), with the Peak Inspiratory Pressure allowed to rise as high as 50 cm of water and the tidal volume at 10 to 15 ml per kilogram. All other ventilatory variables were similar in the two groups. Results A total of 120 patients with similar clinical features underwent randomization (60 in each group). The ...

Rodger Jackson - One of the best experts on this subject based on the ideXlab platform.