Respiratory mechanics during mechanical ventilation: A model study on the effects of leak around a tracheal tube

Kondo, T., Matsumoto, I., Lanteri, C.J. and Sly, P.D. (1997) Respiratory mechanics during mechanical ventilation: A model study on the effects of leak around a tracheal tube. Pediatric Pulmonology, 24 6: 423-428. doi:10.1002/(SICI)1099-0496(199712)24:6<423::AID-PPUL7>3.0.CO;2-H


Author Kondo, T.
Matsumoto, I.
Lanteri, C.J.
Sly, P.D.
Title Respiratory mechanics during mechanical ventilation: A model study on the effects of leak around a tracheal tube
Journal name Pediatric Pulmonology   Check publisher's open access policy
ISSN 8755-6863
1099-0496
Publication date 1997-12
Sub-type Article (original research)
DOI 10.1002/(SICI)1099-0496(199712)24:6<423::AID-PPUL7>3.0.CO;2-H
Volume 24
Issue 6
Start page 423
End page 428
Total pages 6
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Abstract Air leak around a tracheal tube (TT) during mechanical ventilation is likely to occur during the inspiratory phase because airway pressure is high for a prolonged period. The presence of a leak may introduce errors in measurements of respiratory mechanics made at the airway opening. If so, respiratory mechanics can be measured more accurately when data are collected during the expiratory phase of ventilation. We examined this phenomenon in a lung model. When a leak was introduced into the model, simulating a leak around the TT, the leak occurred predominantly during the inspiratory phase of respiration. As the magnitude of the leak increased, the overestimation of resistance progressively increased, when calculated from pressure and flow measured at the airway opening. A large leak (38%) resulted in an overestimation of respiratory system resistance by 51% and an underestimation of elastance (Ers) by 23% when calculated from the entire ventilatory cycle. However, there was no under- or overestimation in Rrs when calculated from the expiratory phase only, and ERs was overestimated by only 6.1%. Varying peak inspiratory pressure, end-expiratory pressure, and expiratory time did influence the effect of leak, however, respiratory mechanics could still be calculated accurately from the expiratory phase under these conditions. We conclude that measurements of lung mechanics from the expiratory phase is a promising approach to dealing with the problem of measuring respiratory mechanics in mechanically ventilated infants with leaks around the tracheal tube.
Keyword Respiratory mechanics
Airway leak
Expiratory phase
Mechanical ventilation
Model studies
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Wed, 17 Nov 2010, 11:34:46 EST