Literature DB >> 20409628

Effect of residual leaning force on intrathoracic pressure during mechanical ventilation in children.

Robert Michael Sutton1, Dana Niles, Jon Nysaether, Mette Stavland, Melissa Thomas, Susan Ferry, Ram Bishnoi, Ronald Litman, Julian Allen, Vijay Srinivasan, Robert A Berg, Vinay M Nadkarni.   

Abstract

AIM: Determine the effect of residual leaning force on intrathoracic pressure (ITP) in healthy children receiving mechanical ventilation. We hypothesized that application of significant residual leaning force (2.5kg or 20% of subject body weight) would be associated with a clinically important change in ITP.
METHODS: IRB-approved pilot study of healthy, anesthetized, paralyzed mechanically ventilated children (6 months to 7 years). Peak endotracheal pressure (ETP), a surrogate of ITP, was continuously measured before and during serial incremental increases in sternal force from 10% to 25% of the subject's body weight. A delta ETP of >or=2.0cmH(2)O was considered clinically significant.
RESULTS: 13 healthy, anesthetized, paralyzed mechanically ventilated children (age: 26+/-24m, range: 6.5-87m; weight: 13+/-5kg, range: 7.4-24.8kg) were enrolled. Peak ETP increased from baseline for all force applications (10% body weight: mean difference of 0.8cmH(2)O, p<0.01; 15% body weight: mean difference of 1.1cmH(2)O, p<0.01; 20% body weight: mean difference of 1.5cmH(2)O, p<0.01; 25% body weight: mean difference of 1.89cmH(2)O, p<0.01). Residual leaning force of >or=2.5kg was associated with a 2.0cmH(2)O change in peak ETP (odds ratio 7.5; CI(95) 1.5-37.7; p=0.014) while sternal force >or=20% body weight was not (odds ratio 2.4; CI(95) 0.6-9.2; p=0.2).
CONCLUSION: In healthy anesthetized children, changes in ETP were detectable at residual leaning forces as low as 10% of subject body weight. Residual leaning force of 2.5kg was associated with increases in ETP >or=2.0cmH(2)O.

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Year:  2010        PMID: 20409628      PMCID: PMC3713479          DOI: 10.1016/j.resuscitation.2010.03.015

Source DB:  PubMed          Journal:  Resuscitation        ISSN: 0300-9572            Impact factor:   5.262


  19 in total

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