Basics of Respiratory Mechanics and Artificial Ventilation by W. A. Zin (auth.), J. Milic-Emili MD, U. Lucangelo MD, A.

By W. A. Zin (auth.), J. Milic-Emili MD, U. Lucangelo MD, A. Pesenti MD, W. A. Zin MD (eds.)

Management of the in depth care sufferer stricken by way of respiration insufficiency calls for wisdom of the pathophysiological foundation for altered capabilities. The etiology and remedy of pulmonary illnesses, reminiscent of acute breathing misery syndrome (ARDS) and protracted obstructive pulmonary ailment (COPD) are hugely complicated. whereas physiologists and pathophysiologists paintings prevalently with theoretical modes, clinicians hire subtle air flow aid applied sciences within the try and comprehend the pathophysiological mechanisms of the pulmonary illnesses that may current with various grades of severity. regardless of the provision of complicated applied sciences it's normal to customize the remedy protocol in response to the patient's physiologic structure.Given the complexity and problems of treating respiration affliction, a powerful collaboration among clinicians and physiologists is of fundamtental importance.

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In general, body mass is an important determinant of lung volume, oxygenation and respiratory mechanics, mainly affecting the lung component. More P. Pelosi, M. Resta, L. Brazzi 28 100 ~ 75 g~ 50 • • I'! ri Ü 25 o+---~--~----~--~--~--~--~ o 10 20 30 40 50 60 70 BMI (kg/m 2 ) 3 • • 2 ü c:: u. oo+--~--~- o 10 20 __-~--~-~-~ 30 40 BMI (kg/m 2 ) 50 60 70 Fig. 4. Relationship between body mass index and compliance of respiratory system (Cst,rs), functional residual capacity (FRC), and oxygenation (PaOz/PAOz) importantly, alterations in respiratory mechanics are present not only in patients with severe obesity, but also in patients with moderate obesity.

It is sufficient for a number of porposes, and allows following the changes of Rrs during breathing with a time resolution equal to the reciprocal of the frequency [50]. When measurements at several frequencies are needed, either to study the frequency dependence of Rrs, or to compute Ers and Irs, one may either repeat the measurements with different sine waves, or use a signal containing either an infinity of random frequency components (white noise [51]) or a predetermined set of frequencies (pseudorandom noise (PRN) [52]).

Glottis closure or occlusion of the mouthpiece with the tongue are frequent causes of faulty manoeuvers. ßV/Vmay be non-linear, asymmetrical, and present a substantial degree of looping in severely obstructive patients (Fig. 2a). Three to five satisfactory measurements are usually obtained. Variants of this protocol may be used but it is essential that ß VIPmo and ß VIVare measured at precisely the same lung volume, or that any change in volume between the two measurements is measured and used to correct the value of TGV entered in Eq.

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