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  • 标题:Clinical Application of Respiratory Elastance (CARE Trial) for Mechanically Ventilated Respiratory Failure Patients: A Model-based Study
  • 本地全文:下载
  • 作者:Yeong Shiong Chiew ; J. Geoffrey Chase ; Ganesaramachandran Arunachalam
  • 期刊名称:IFAC PapersOnLine
  • 印刷版ISSN:2405-8963
  • 出版年度:2018
  • 卷号:51
  • 期号:27
  • 页码:209-214
  • DOI:10.1016/j.ifacol.2018.11.641
  • 语种:English
  • 出版社:Elsevier
  • 摘要:AbstractMechanical ventilation (MV) is the primary support for respiratory failure patients. MV treatment is difficult to manage due to the variable patient-specific disease state and response to MV treatment. Model-based methods have shown potential in providing unique, personalised information on patient condition for clinicians to guide MV treatment. This study presents a clinical observational trial to investigate the respiratory mechanics and quality of patient ventilator asynchrony conducted in a South-East Asia hospital intensive care unit (ICU). Pilot trial results included 7 study patients. Patient-specific respiratory mechanicsErsandRrswere median 32.30 cmH2O/l [Interquartile range (IQR): 24.53-43.48] and 7.62 cmH2Os/l [IQR: 4.85-10.34]. The Normalised Area Under the Curve of Time-Varying Elastance(AUC-Edrs)across patients were 27.50 cmH2O/l [IQR: 24.97-28.34]. Patient ventilator interaction is assessed using an asynchrony index (AI), where AI had a median value of 27.0% [(IQR): 21.0-52.7]. Patient-specific respiratory mechanics displayed intra- and inter- patient variability, suggesting patients are different and evolved over time, and thus their MV settings should be patient-specific and time-varying. Model-based methods thus offer unique insight into patient-specific respiratory mechanics and the resulting opportunity to personalize and optimise MV based on evolving patient-specific needs.
  • 关键词:KeywordsModel-based MethodsRespiratory MechanicsMechanical VentilationRespiratory Failure
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