A computerized method for measuring respiratory mechanics during mechanical ventilation.

Abstract

In order to monitor respiratory mechanics in anesthetized ventilated subjects, an automated method was developed and tested on a physical model. The model was composed of an endotracheal tube (curvilinear resistance) coupled to a rigid air-filled box (elastance). Theoretical resistance was determined during steady-state flow experiments and theoretical elastance was estimated from the dimensions of the box. The physical model was connected to a volume-cycled ventilator. Pressure (P) and air flow (V) were measured at the outlet of the tube, and the time integral V of V was calculated. Elastance (E) and curvilinear resistance (R + K/V/) were identified by multiple linear regression analysis, for each ventilatory cycle, according to equation P = EV + RV + K/V/V. When linear regression analysis of P on V, V and /V/V was performed over the entire ventilatory cycle, E was found equal to its estimate, whereas R and K appeared different from their theoretical values. In order to improve determination of R and K, resistive pressure (Pr = P - EV) was calculated using the previously obtained value of E, and multiple linear regression of Pr on V and /V/V was performed over different fractions of the ventilatory cycle. When determined over the expiratory phase corresponding to decreasing flows, R and K were found close to their expected values. Such a method to calculate elastance and curvilinear resistance should prove convenient and efficient in measuring respiratory mechanics during mechanical ventilation.