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Validation and clinical feasibility of nitrogen washin/washout functional residual capacity measurements in children.

Artikel i vetenskaplig tidskrift
Författare Cecilia Olegård
Sören Söndergaard
Jan Pålsson
Stefan Lundin
Ola Stenqvist
Publicerad i Acta anaesthesiologica Scandinavica
Volym 54
Nummer/häfte 3
Sidor 370-6
ISSN 1399-6576
Publiceringsår 2010
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård
Sidor 370-6
Språk en
Länkar dx.doi.org/10.1111/j.1399-6576.2009...
Ämnesord Algorithms, Anesthesia, General, Blood Gas Analysis, Carbon Dioxide, blood, Child, Feasibility Studies, Female, Functional Residual Capacity, physiology, Humans, Intensive Care, Male, Models, Anatomic, Nitrogen, analysis, metabolism, Positive-Pressure Respiration, Reproducibility of Results, Respiration, Artificial
Ämneskategorier Medicin och Hälsovetenskap

Sammanfattning

BACKGROUND: The functional residual capacity (FRC) is an important parameter in pediatric respiratory monitoring but it is difficult to assess in the clinical setting. We have introduced a modified N(2) washout method utilizing a change of F(I)O(2) of 0.1 for FRC measurement in adult respiratory monitoring. This study validated the algorithm in a pediatric lung model and investigated the stability and feasibility in a pediatric peri-operative and intensive care setting. METHODS: The lung model was ventilated in combinations of ventilatory modes, CO(2) production, model FRC and respiratory rates. Sixteen children from 10 days to 5 years were studied peri-operatively with controlled ventilation using a Mapleson D system and in the intensive care unit using a Servo-i ventilator in a supported spontaneous mode. FRC was measured during stable metabolic, respiratory and circulatory periods at positive end expiratory pressure of 3-4 and 7-8 cmH(2)O. RESULTS: In the model and in the clinical setting, we found an excellent agreement between washout and washin measurements of FRC as well as acceptable coefficients of repeatability. CONCLUSION: FRC was satisfactorily measured by a modified N(2) algorithm and may be included as a monitoring variable in pediatric respiratory care. Pediatric FRC monitoring demands strictly stable conditions as measurements are performed close to the limits of the monitor's specifications.

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