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Inspiratory effort and breathing pattern change in response to varying the assist level: A physiological study.
Lilitsis, Emmanouil; Stamatopoulou, Vaia; Andrianakis, Eleftherios; Petraki, Adamantia; Antonogiannaki, Elvira-Markela; Georgopoulos, Dimitrios; Vaporidi, Katerina; Kondili, Eumorfia.
  • Lilitsis E; Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Voutes, 71110, Heraklion, Crete, Greece.
  • Stamatopoulou V; Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Voutes, 71110, Heraklion, Crete, Greece.
  • Andrianakis E; Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Voutes, 71110, Heraklion, Crete, Greece.
  • Petraki A; Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Voutes, 71110, Heraklion, Crete, Greece.
  • Antonogiannaki EM; Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Voutes, 71110, Heraklion, Crete, Greece.
  • Georgopoulos D; Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Voutes, 71110, Heraklion, Crete, Greece.
  • Vaporidi K; Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Voutes, 71110, Heraklion, Crete, Greece.
  • Kondili E; Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Voutes, 71110, Heraklion, Crete, Greece. Electronic address: kondylie@uoc.gr.
Respir Physiol Neurobiol ; 280: 103474, 2020 09.
Article in English | MEDLINE | ID: covidwho-592467
ABSTRACT

AIM:

To describe the response of breathing pattern and inspiratory effort upon changes in assist level and to assesss if changes in respiratory rate may indicate changes in respiratory muscle effort.

METHODS:

Prospective study of 82 patients ventilated on proportional assist ventilation (PAV+). At three levels of assist (20 %-50 %-80 %), patients' inspiratory effort and breathing pattern were evaluated using a validated prototype monitor.

RESULTS:

Independent of the assist level, a wide range of respiratory rates (16-35br/min) was observed when patients' effort was within the accepted range. Changing the assist level resulted in paired changes in inspiratory effort and rate of the same tendency (increase or decrease) in all but four patients. Increasing the level in assist resulted in a 31 % (8-44 %) decrease in inspiratory effort and a 10 % (0-18 %) decrease in respiratory rate. The change in respiratory rate upon the change in assist correlated modestly with the change in the effort (R = 0.5).

CONCLUSION:

Changing assist level results in changes in both respiratory rate and effort in the same direction, with change in effort being greater than that of respiratory rate. Yet, neither the magnitude of respiratory rate change nor the resulting absolute value may reliably predict the level of effort after a change in assist.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Inhalation / Work of Breathing / Respiratory Rate / Interactive Ventilatory Support Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Respir Physiol Neurobiol Year: 2020 Document Type: Article Affiliation country: J.resp.2020.103474

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Inhalation / Work of Breathing / Respiratory Rate / Interactive Ventilatory Support Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Respir Physiol Neurobiol Year: 2020 Document Type: Article Affiliation country: J.resp.2020.103474