scholarly journals Expiratory flow limitation in mechanical ventilation: a model study of lung non-homogeneities

2005 ◽  
Author(s):  
C. Brighenti ◽  
P. Barbini ◽  
G. Cevenini ◽  
G. Gnudi
Keyword(s):  
Mechanical Ventilation ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Model Study ◽  
Expiratory Flow

Lung and chest wall mechanics in patients with acute respiratory distress syndrome, expiratory flow limitation, and airway closure

2020 ◽  
Vol 128 (6) ◽  
pp. 1594-1603 ◽  
Author(s):  
Claude Guérin ◽  
Nicolas Terzi ◽  
Louis-Marie Galerneau ◽  
Mehdi Mezidi ◽  
Hodane Yonis ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Distress Syndrome ◽  
Flow Limitation ◽  
Airway Closure ◽  
Positive End Expiratory Pressure ◽  
Expiratory Flow Limitation ◽  
Lung Elastance ◽  
Chest Wall Mechanics ◽  
Expiratory Flow ◽  
Better Than

Expiratory flow limitation (EFL) and airway closure (AC) were observed in 32% and 52%, respectively, of 25 patients with ARDS investigated during mechanical ventilation in supine position with a positive end-expiratory pressure of 5 cmH2O. The performance of dynamic lung elastance to detect expiratory flow limitation was good and better than that to detect airway closure. The vast majority of patients with EFL also had AC; however, AC can occur in the absence of EFL.

scholarly journals Expiratory flow limitation in intensive care: prevalence and risk factors

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Carlo Alberto Volta ◽  
Francesca Dalla Corte ◽  
Riccardo Ragazzi ◽  
Elisabetta Marangoni ◽  
Alberto Fogagnolo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Fluid Balance ◽  
Adverse Outcomes ◽  
Small Airways ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Expected Length ◽  
Expiratory Flow

Abstract Background Expiratory flow limitation (EFL) is characterised by a markedly reduced expiratory flow insensitive to the expiratory driving pressure. The presence of EFL can influence the respiratory and cardiovascular function and damage the small airways; its occurrence has been demonstrated in different diseases, such as COPD, asthma, obesity, cardiac failure, ARDS, and cystic fibrosis. Our aim was to evaluate the prevalence of EFL in patients requiring mechanical ventilation for acute respiratory failure and to determine the main clinical characteristics, the risk factors and clinical outcome associated with the presence of EFL. Methods Patients admitted to the intensive care unit (ICU) with an expected length of mechanical ventilation of 72 h were enrolled in this prospective, observational study. Patients were evaluated, within 24 h from ICU admission and for at least 72 h, in terms of respiratory mechanics, presence of EFL through the PEEP test, daily fluid balance and followed for outcome measurements. Results Among the 121 patients enrolled, 37 (31%) exhibited EFL upon admission. Flow-limited patients had higher BMI, history of pulmonary or heart disease, worse respiratory dyspnoea score, higher intrinsic positive end-expiratory pressure, flow and additional resistance. Over the course of the initial 72 h of mechanical ventilation, additional 21 patients (17%) developed EFL. New onset EFL was associated with a more positive cumulative fluid balance at day 3 (103.3 ml/kg) compared to that of patients without EFL (65.8 ml/kg). Flow-limited patients had longer duration of mechanical ventilation, longer ICU length of stay and higher in-ICU mortality. Conclusions EFL is common among ICU patients and correlates with adverse outcomes. The major determinant for developing EFL in patients during the first 3 days of their ICU stay is a positive fluid balance. Further studies are needed to assess if a restrictive fluid therapy might be associated with a lower incidence of EFL.

Late Breaking Abstract - Non-interventional monitoring of expiratory flow limitation during experimental mechanical ventilation

2020 ◽  
Author(s):  
Giorgos Marinakis ◽  
Michael Paraschos ◽  
Maria Patrani ◽  
Theodoros Tsoutsouras ◽  
Athanasia Kotrotsou ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Expiratory Flow

scholarly journals Expiratory Flow Limitation During Mechanical Ventilation

CHEST Journal ◽  
2018 ◽  
Vol 154 (4) ◽  
pp. 948-962 ◽  
Author(s):  
Detajin Junhasavasdikul ◽  
Irene Telias ◽  
Domenico Luca Grieco ◽  
Lu Chen ◽  
Cinta Millan Gutierrez ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Expiratory Flow

Time Course of Expiratory Flow Limitation in COPD Patients During Acute Respiratory Failure Requiring Mechanical Ventilation

CHEST Journal ◽  
2003 ◽  
Vol 123 (5) ◽  
pp. 1625-1632 ◽  
Author(s):  
Valentina Alvisi ◽  
Anna Romanello ◽  
Michel Badet ◽  
Sandrine Gaillard ◽  
Francois Philit ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Time Course ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Copd Patients ◽  
Expiratory Flow

Detection of expiratory flow limitation during mechanical ventilation.

1994 ◽  
Vol 150 (5) ◽  
pp. 1311-1317 ◽  
Author(s):  
P Valta ◽  
C Corbeil ◽  
A Lavoie ◽  
R Campodonico ◽  
N Koulouris ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Expiratory Flow

scholarly journals Effect of expiratory flow limitation on respiratory mechanical impedance: a model study

1996 ◽  
Vol 81 (6) ◽  
pp. 2399-2406 ◽  
Author(s):  
R. Peslin ◽  
R. Farré ◽  
M. Rotger ◽  
D. Navajas
Keyword(s):  
Respiratory System ◽  
Input Impedance ◽  
Wave Speed ◽  
Mechanical Impedance ◽  
Flow Limitation ◽  
Maximal Flow ◽  
Expiratory Flow Limitation ◽  
Rubber Tubing ◽  
Model Study ◽  
Expiratory Flow

Peslin, R., R. Farré, M. Rotger, and D. Navajas.Effect of expiratory flow limitation on respiratory mechanical impedance: a model study. J. Appl. Physiol. 81(6): 2399–2406, 1996.—Large phasic variations of respiratory mechanical impedance (Zrs) have been observed during induced expiratory flow limitation (EFL) (M. Vassiliou, R. Peslin, C. Saunier, and C. Duvivier. Eur. Respir. J. 9: 779–786, 1996). To clarify the meaning of Zrs during EFL, we have measured from 5 to 30 Hz the input impedance (Zin) of mechanical analogues of the respiratory system, including flow-limiting elements (FLE) made of easily collapsible rubber tubing. The pressures upstream (Pus) and downstream (Pds) from the FLE were controlled and systematically varied. Maximal flow (V˙max) increased linearly with Pus, was close to the value predicted from wave-speed theory, and was obtained for Pus-Pds of 4–6 hPa. The real part of Zin started increasing abruptly with flow (V˙) >85%V˙max and either further increased or suddenly decreased in the vicinity of V˙max. The imaginary part of Zin decreased markedly and suddenly above 95%V˙max. Similar variations of Zin during EFL were seen with an analogue that mimicked the changes of airway transmural pressure during breathing. After pressure andV˙ measurements upstream and downstream from the FLE were combined, the latter was analyzed in terms of a serial (Zs) and a shunt (Zp) compartment. Zs was consistent with a large resistance and inertance, and Zp with a mainly elastic element having an elastance close to that of the tube walls. We conclude that Zrs data during EFL mainly reflect the properties of the FLE.

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