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Capnodynamic assessment of effective lung volume during cardiac output manipulations in a porcine model
Karolinska Univ Hosp, Dept Anesthesiol Surg Serv & Intens Care Med, S-17176 Stockholm, Sweden.;Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden..
Karolinska Univ Hosp, Astrid Lindgrens Childrens Hosp, Paediat Anesthesia & Intens Care, Stockholm, Sweden..
Maquet Crit Care AB, Solna, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Hedenstierna laboratory. Inst Carlos III, CIBERES, CIBER Enfermedades Resp, Madrid, Spain..
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2016 (English)In: Journal of clinical monitoring and computing, ISSN 1387-1307, E-ISSN 1573-2614, Vol. 30, no 6, 761-769 p.Article in journal (Refereed) Published
Abstract [en]

A capnodynamic calculation of effective pulmonary blood flow includes a lung volume factor (ELV) that has to be estimated to solve the mathematical equation. In previous studies ELV correlated to reference methods for functional residual capacity (FRC). The aim was to evaluate the stability of ELV during significant manipulations of cardiac output (CO) and assess the agreement for absolute values and trending capacity during PEEP changes at different lung conditions. Ten pigs were included. Alterations of alveolar carbon dioxide were induced by cyclic reoccurring inspiratory holds. The Sulphur hexafluoride technique for FRC measurements was used as reference. Cardiac output was altered by preload reduction and inotropic stimulation at PEEP 5 and 12 cmH(2)O both in normal lung conditions and after repeated lung lavages. ELV at baseline PEEP 5 was [mean (SD)], 810 (163) mL and decreased to 400 (42) mL after lavage. ELV was not significantly affected by CO alterations within the same PEEP level. In relation to FRC the overall bias (limits of agreement) was -35 (-271 to 201) mL, and percentage error 36 %. A small difference between ELV and FRC was seen at PEEP 5 cmH(2)O before lavage and at PEEP 12 cmH(2)O after lavage. ELV trending capability between PEEP steps, showed a concordance rate of 100 %. ELV was closely related to FRC and remained stable during significant changes in CO. The trending capability was excellent both before and after surfactant depletion.

Place, publisher, year, edition, pages
2016. Vol. 30, no 6, 761-769 p.
Keyword [en]
Monitoring, Capnodynamic method, Effective lung volume, Porcine model, Lung lavage
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:uu:diva-309788DOI: 10.1007/s10877-015-9767-7ISI: 000387229400004PubMedID: 26377022OAI: oai:DiVA.org:uu-309788DiVA: diva2:1058744
Funder
Stockholm County CouncilThe Karolinska Institutet's Research Foundation
Available from: 2016-12-21 Created: 2016-12-07 Last updated: 2016-12-21Bibliographically approved

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Suarez Sipmann, Fernando
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Anaesthesiology and Intensive CareHedenstierna laboratory
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