1991 Fiscal Year Final Research Report Summary
New Ventilatory Assistance in Reducing work of Breathing in Respiratory Failure
| Project/Area Number |
01570860
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
麻酔学
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| Research Institution | Grant-in-Aid for Scientific Research (C) |
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Principal Investigator |
TAKEZAWA Jun Associate Professor, Icu, Nagoya University, 医学部, 講師 (20116057)
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| Co-Investigator(Kenkyū-buntansha) |
KIMURA Tomomasa Associate Professor, Dept. of Anesthesiology, Nagoya University, 医学部, 講師
SHIMADA Yasuhiro Professor, Dept. of Anesthesiology, Nagoya University, 医学部, 教授 (50028669)
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| Project Period (FY) |
1989 – 1991
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| Keywords | Lung model / Respiratory failure / Pressure support / Work of Breathing / Artificial ventilation / Pleural pressure / Alveolar pressure |
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| 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.
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