2002 OPEN FORUM Abstracts
RELIABILITY OF MEASURED TIDAL VOLUME IN MECHANICALLY VENTILATED PIGLETS
Mark J. Heulitt MD, Patricia C. Wankum MD, Shirley J. Holt RRT, Tracy L. Thurman, Renée A. Hall, M.S. and Pippa Simpson, Ph.D. Pediatrics, UAMS/Arkansas Children?s Hospital, Little Rock, AR.
Background: The goals of modern mechanical ventilation in infants and children have focused on preventing overdistention by limiting tidal volume, thus volutrauma. Exact knowledge of both inspired and expired gas volumes with a sufficient level of precision is essential to optimize ventilator settings utilizing this lung protective technique. However, the optimal site for monitoring volumes in these patients is unclear.
Objective: The objective of our study was to determine if volumes could be accurately measured utilizing pressure support ventilation (PSV) and positive end expiratory pressure (PEEP) in piglets utilizing software compensation for circuit compliance measured at the ventilator.
Methods: Volume measurements were performed, on six neonatal and six pediatric piglets, ventilated with the Servoi? using PSV and PEEP, with and without circuit compliance compensation. We compared volume measured at the airway utilizing a pneumotachograph to volume measured at the ventilator.
Results: The use of circuit compliance compensation improves the agreement between the two volume methods for neonates (median, range: 0.84, 0.64-0.91 vs. 0.92, 0.70-0.96). Among pediatric animals, there is improvement in agreement between the two volume methods attributable to circuit compliance compensation (0.69, 0.39-0.97 vs. 0.92, 0.68-0.96). In addition, the variability in agreement lessens with circuit compliance compensation.
Conclusions: Our results show that volume can be accurately measured away from the airway in neonatal and pediatric patients if circuit compliance is compensated.
Disclosure: Unrestricted grant from Siemens Medical Systems