Noninvasive method for measuring respiratory system compliance during pressure support ventilation

Abstract

Purpose: To date, few methods have been accepted for assessing the respiratory system compliance (C(rs)) in patients under assisted ventilation at the bedside. The aim of this study was to evaluate our adaptive time slice method (ATSM) to continuously calculate the C(rs).

Methods: One breath is divided into several time periods (slices). For each slice, a compliance value C(i) is calculated. The slice width is adapted according to the confidence interval of C(i). After all C(i) values are obtained and the outliers are eliminated, the C(rs) of this breath is calculated as the mean value of the remainder of C(i)'s. Seven patients with Chronic Obstructive Pulmonary Disease were evaluated during pressure support ventilation. The results are compared with the values calculated with the transdiaphragmatic pressure (P(di)).

Results: 95 ± 4% of the recorded data could be analyzed with ATSM. In 6 patients out of 7, the results delivered with ATSM and with P(di) had similar variation (standard deviation) and accuracy (difference<20%). They were strongly correlated (weighted correlation coefficient = 0.86, p<10(-5)) with a mean difference of 3.22 ml/mbar.

Conclusions: The ATSM is a robust method and able to provide accurate C(rs) in spontaneously breathing patients during pressure support ventilation noninvasively without extra instrumentation or complicated maneuvers.