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New Ventilatory Assistance in Reducing work of Breathing in Respiratory Failure

Research Project

Project/Area Number 01570860
Research Category

Grant-in-Aid for General Scientific Research (C)

Allocation TypeSingle-year Grants
Research Field 麻酔学
Research InstitutionGrant-in-Aid for Scientific Research (C)

Principal Investigator

TAKEZAWA Jun  Associate Professor, Icu, Nagoya University, 医学部, 講師 (20116057)

Co-Investigator(Kenkyū-buntansha) KIMURA Tomomasa  Associate Professor, Dept. of Anesthesiology, Nagoya University, 医学部, 講師 (50161568)
SHIMADA Yasuhiro  Professor, Dept. of Anesthesiology, Nagoya University, 医学部, 教授 (50028669)
Project Period (FY) 1989 – 1991
Project Status Completed (Fiscal Year 1991)
Budget Amount *help
¥2,200,000 (Direct Cost: ¥2,200,000)
Fiscal Year 1991: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 1990: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1989: ¥700,000 (Direct Cost: ¥700,000)
KeywordsLung model / Respiratory failure / Pressure support / Work of Breathing / Artificial ventilation / Pleural pressure / Alveolar pressure / プレッシャ-サポ-ト
Research Abstract

We developed the spring-loaded bellows type lung model which allowed us to simulates spontaneous breathing. With this lung model, we evaluated the patient (lung model)-ventilator interactions during partial ventilatory assistance, especially pressure support ventilation (PSV). A various levels of PSV was delivered to the lung model with different impedance and airway, alveolar and pleural pressure fluctuations were recorded. We found that in the lung with low compliance, pressure support prematurely terminated, resulting in insufficient assistance of inspiratory efforts. To overcome this problem, we proposed the use of pressure control ventilation with prolonged inspiratory time for matching the patient inspiratory time. This can be achieved by monitoring the esophageal pressure fluctuations in the clinical settings. In the lung with high airway resistance, a delay in triggering the ventilator, prolonged pressure supporting time and concomitant development of auto-PEEP became the big problem. To solve these problem, a use of pressure control ventilation with a matched inspiratory time for patient real inspiratory time is advisable. Alternatively, PCV with a adjustable flow termination criteria may be helpful in improving the patient-ventilator synchrony. It is concluded that although PSV greatly improved the patient-ventilator synchrony, a serious problems still remain in its application to the lung with either low compliance or high airway resistance.

Report

(4 results)
  • 1991 Annual Research Report   Final Research Report Summary
  • 1990 Annual Research Report
  • 1989 Annual Research Report
  • Research Products

    (27 results)

All Other

All Publications (27 results)

  • [Publications] Kocmarek RM: "The Second Nagoya Conference:Tiggering and optimizing anechanical Ventilatory assist" Respir Care. 36. 45-51 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Kimura T: "Determination of the optinal Pressure Support lerel evaluated by measuring transdiaphamatic phessure" Chest. 100. 112-117 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Takahashi T: "Comparison of inspiratory work of breathing in T-Pice breathing Pressure Support Ventilation and Pleural Pressure Support Ventilation (PPSV)" Chest. 100. 1030-1034 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Kacmarek RM, Shimada Y, Ohmura A, Takezawa, J, Tokioka H, Kimura T, Nishimura M: "The second N agoya conference : Triggering and optimizing mechanical ventilatory assist" Respir Care. 36. 45-51 (1991)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Kimura T, Takezawa J, Nishiwaki K, Shimada Y :"Determination of optimal pressure support level evaluated by measuring transdiaphragmatic pressure" Chest. 100. 112-117 (1991)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Takahashi T, Takezawa J, Kimura T, Nishiwaki Y, Shimada Y: "Comparison of inspiratory work of breathing in T-piece breathing, pressure support ventilation and pleural pressure support ventilation (PPSV)." Chest. 100. 1030-1034 (1991)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Kacmarek RM: "The Second Nagaya Conference:Triggering and opimizing mechanical vehtilatoty assist" Resper Care. 36. 45-51 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] Kimura T: "Determination of the optimal pressure support level evaluated by measuring transdiaphragmatic pressure" Chest. 100. 112-117 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] Takahashi T: "Comparison of inspiratory work of breathing in Tーpice breathing,Pressure Support ventilation and pleural pressure support vantilation(PPSV)" Chest. 100. 1030-1034 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] 武澤 純: "人工換気における呼吸気比の考え方ーInverse Ratio ventilation(IRV)ー(教育講演)" 日本臨床酔学会誌. 11. 163-168 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] 島田 康弘: "呼吸仕事量は機械的な換気補助のパラメ-タ-となりえるか?" 人工呼吸. 8. 31-59 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] 桑山 直人: "人工呼吸中の換気力学的センタ-" 臨床モニタ-. 2. 455-462 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] 武澤 純: "人工呼吸の種類と特徴III.IMV(SIMV)とプレッシャ-サポ-ト換気" 74-84 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] 武澤 純: "ICU患者における胃内細菌と肺炎" 59-63 (1992)

    • Related Report
      1991 Annual Research Report
  • [Publications] 武澤 純: "The Nagoya conference on system design and patientーventilator intilator interactions during pressure support ventilation" CHEST. 97. 1463-1466 (1989)

    • Related Report
      1990 Annual Research Report
  • [Publications] 武澤 純: "第3世代人工呼吸器のcPAPおよびPSV時の気道内圧制御様式の比較検討" 人工呼吸. 6. 60-63 (1989)

    • Related Report
      1990 Annual Research Report
  • [Publications] 武澤 純: "人工呼吸管理の工夫ー食道内圧、胃内圧を用いた換気力学的モンタリングの有用性" 人工呼吸. 7. 38-42 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] Nishiwaki K.: "LIMITATION OF PRESSURE SUPPORT VENTILATION IN THE LUNG WITH HIGH RESISTANCE" Critical Care Medicine.

    • Related Report
      1990 Annual Research Report
  • [Publications] TAKEZAWA J: "A NEW CONCEPT OF VENTILATOR WITH A PRECISE CONTROL OF AIRWAY PRESSURE USING ELECTRONIC INTERFACED INSPIRATORY AND EXPIRATORY VALVES" Critical Care Medicine.

    • Related Report
      1990 Annual Research Report
  • [Publications] Kuwayama N.: "AUTOーPEEP DURING PRESSURE SUPPORT VENTILATION IN THE LUNG WITH HIGH AIRWAY RESISTANCE" CHEST.

    • Related Report
      1990 Annual Research Report
  • [Publications] 桑山 直人: "Clinical Engineering" 各種人工換気法:(S)IMV,PSV,(E)MMV, 6 (1991)

    • Related Report
      1990 Annual Research Report
  • [Publications] 武澤純: "プレッシャ-サポ-ト換気と呼吸仕事量-人工呼吸の新しい潮流-(座談会)" 呼吸. 8. 914-929 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] 武澤純: "プレッシャ-サポ-ト換気(総論)" 人工呼吸. 6. 9-16 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] Takezawa J.: "PLEURAL PRESSURE SUPPORT VENTILATION(PPSV):A NEW MODE OF MECHANICAL VENTILATION TO SUPPORT SPONTANEOUS BREATHING" CRITICAL CARE MEDICINE. 17. S33 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] Takezawa J.: "A NEW LUNG MODEL FOR MEASUREMENT OF WORK OF BREATHING IN SIMULATED SPONTANEOUS BREATHING DURING MECANICALVENTILATORY ASSIST." CHEST. 96. 257S (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] Takahashi T.: "AN EXCESSIVE RISE IN PLEURAL PRESSURE DURING A HIGH LEVEL OF PRESSURE SUPPORT VENTILATION" CHEST. 96. 258S (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] Kimura T.: "LIMITATION OF PRESSURE SUPPORT VENTILATION(PSV) IN THE LUNG WITH LOW COMPLIANCE" CHEST. 96. 257 (1989)

    • Related Report
      1989 Annual Research Report

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Published: 1989-04-01   Modified: 2016-04-21  

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