Measurement of Lung Volume in Mechanically Ventilated Monkeys with an Ultrasonic Flow Meter and the Nitrogen Washout Method

Overview

Journal Intensive Care Med

Specialty Critical Care

Date 2003 Oct 8

PMID 14530860

Citations 9

Authors

Andreas Schibler

Jurg Hammer

Ruedi Isler

Christian Buess

Christopher J L Newth

Affiliations

Soon will be listed here.

Abstract

Objective: Measurement of functional residual capacity (FRC) during mechanical ventilation is important to standardise respiratory system compliance and adjust the ventilator settings to optimise lung recruitment. In the present study we compared three methods to measure FRC.

Design: The bias flow nitrogen washout technique (FRC(N2MC)), the multiple breath nitrogen washout (FRC(MBNW)) and the multiple breath sulphur-hexafluoride washout using the molar mass signal of an ultrasonic flow meter (FRC(MBSF6)) were compared in six adult monkeys after endotracheal intubation and during spontaneous breathing and mechanical ventilation at three different positive end-expiratory pressure (PEEP) levels of 0, 5 and 10 cmH2O.

Setting: Animal research laboratory.

Results: We found good agreement between all three methods and they all accurately measured changes in FRC when PEEP was increased. The coefficients of variance of the three measurement techniques were in the same range (1.3-9.2%).

Conclusion: The measurement of the tracer gas concentration with the molar mass signal of the ultrasonic flow meter provides a good and simple alternative to respiratory mass spectrometer for FRC measurements in ventilated subjects.

Citing Articles

An Official American Thoracic Society/European Respiratory Society Workshop Report: Evaluation of Respiratory Mechanics and Function in the Pediatric and Neonatal Intensive Care Units.

Peterson-Carmichael S, Seddon P, Cheifetz I, Frerichs I, Hall G, Hammer J Ann Am Thorac Soc. 2016; 13(2):S1-11.

PMID: 26848609 PMC: 5461957. DOI: 10.1513/AnnalsATS.201511-730ST.

Elevated positive end-expiratory pressure decreases cardiac index in a rhesus monkey model.

Ross P, Khemani R, Rubin S, Bhalla A, Newth C Front Pediatr. 2014; 2:134.

PMID: 25520944 PMC: 4253666. DOI: 10.3389/fped.2014.00134.

Respiratory inductance plethysmography calibration for pediatric upper airway obstruction: an animal model.

Khemani R, Flink R, Hotz J, Ross P, Ghuman A, Newth C Pediatr Res. 2014; 77(1-1):75-83.

PMID: 25279987 PMC: 4268304. DOI: 10.1038/pr.2014.144.

Lung volume assessments in normal and surfactant depleted lungs: agreement between bedside techniques and CT imaging.

Albu G, Petak F, Zand T, Hallback M, Wallin M, Habre W BMC Anesthesiol. 2014; 14:64.

PMID: 25143759 PMC: 4134664. DOI: 10.1186/1471-2253-14-64.

A realistic validation study of a new nitrogen multiple-breath washout system.

Singer F, Houltz B, Latzin P, Robinson P, Gustafsson P PLoS One. 2012; 7(4):e36083.

PMID: 22558338 PMC: 3338632. DOI: 10.1371/journal.pone.0036083.

References

Schibler A, Schneider M, Frey U, Kraemer R . Moment ratio analysis of multiple breath nitrogen washout in infants with lung disease. Eur Respir J. 2000; 15(6):1094-101. DOI: 10.1034/j.1399-3003.2000.01518.x. View

Sivan Y, Deakers T, Newth C . Effect of positive end-expiratory pressure on respiratory compliance in children with acute respiratory failure. Pediatr Pulmonol. 1991; 11(2):103-7. DOI: 10.1002/ppul.1950110205. View

Schulze A, Schaller P, Topfer A, Kirpalani H . Measurement of functional residual capacity by sulfur hexafluoride in small-volume lungs during spontaneous breathing and mechanical ventilation. Pediatr Res. 1994; 35(4 Pt 1):494-9. View

Sivan Y, Deakers T, Newth C . Functional residual capacity in ventilated infants and children. Pediatr Res. 1990; 28(5):451-4. DOI: 10.1203/00006450-199011000-00006. View

Vilstrup C, Bjorklund L, Larsson A, Lachmann B, Werner O . Functional residual capacity and ventilation homogeneity in mechanically ventilated small neonates. J Appl Physiol (1985). 1992; 73(1):276-83. DOI: 10.1152/jappl.1992.73.1.276. View

Brunner J, Wolff G, Cumming G, Langenstein H . Accurate measurement of N2 volumes during N2 washout requires dynamic adjustment of delay time. J Appl Physiol (1985). 1985; 59(3):1008-12. DOI: 10.1152/jappl.1985.59.3.1008. View

Sivan Y, Deakers T, Newth C . An automated bedside method for measuring functional residual capacity by N2 washout in mechanically ventilated children. Pediatr Res. 1990; 28(5):446-50. DOI: 10.1203/00006450-199011000-00005. View

Wauer J, Leier T, Henschen M, Wauer R, Schmalisch G . In vitro validation of an ultrasonic flowmeter in order to measure the functional residual capacity in newborns. Physiol Meas. 2003; 24(2):355-65. DOI: 10.1088/0967-3334/24/2/311. View

Hammer J, Numa A, Newth C . Total lung capacity by N2 washout from high and low lung volumes in ventilated infants and children. Am J Respir Crit Care Med. 1998; 158(2):526-31. DOI: 10.1164/ajrccm.158.2.9710096. View

10.

Schibler A, Henning R . Positive end-expiratory pressure and ventilation inhomogeneity in mechanically ventilated children. Pediatr Crit Care Med. 2003; 3(2):124-128. DOI: 10.1097/00130478-200204000-00006. View

11.

Rimensberger P, Bryan A . Measurement of functional residual capacity in the critically ill. Relevance for the assessment of respiratory mechanics during mechanical ventilation. Intensive Care Med. 1999; 25(5):540-2. DOI: 10.1007/s001340050897. View

12.

Wrigge H, Sydow M, Zinserling J, Neumann P, Hinz J, Burchardi H . Determination of functional residual capacity (FRC) by multibreath nitrogen washout in a lung model and in mechanically ventilated patients. Accuracy depends on continuous dynamic compensation for changes of gas sampling delay time. Intensive Care Med. 1998; 24(5):487-93. DOI: 10.1007/s001340050601. View

13.

Schibler A, Henning R . Measurement of functional residual capacity in rabbits and children using an ultrasonic flow meter. Pediatr Res. 2001; 49(4):581-8. DOI: 10.1203/00006450-200104000-00022. View