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Case Reports
. 2021 Jun 1;25(1):187.
doi: 10.1186/s13054-021-03619-0.

Potential protective effects of continuous anterior chest compression in the acute respiratory distress syndrome: physiology of an illustrative case

Guillaume Carteaux  1   2   3 , Samuel Tuffet  4   5   6 , Armand Mekontso Dessap  4   5
Affiliations
Case Reports

Potential protective effects of continuous anterior chest compression in the acute respiratory distress syndrome: physiology of an illustrative case

Guillaume Carteaux et al. Crit Care. .
No abstract available

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Conflict of interest statement

GC reports personal fees from Air Liquide Medical System, Medtronic and Löwenstein, outside the submitted work. AMD reports grants from Fischer Paykel, Baxter, Philips, Ferring and GSK, personal fees from Air Liquide, Baxter, Amomed, Getinge and Addmedica, outside the submitted work. ST reports no competing interest.

Figures

Fig. 1
Fig. 1
Effect of continuous anterior chest compression on respiratory mechanics and lung aeration. The patient was ventilated in assist control ventilation with a tidal volume of 350 ml in three different conditions: PEEP 6: with a PEEP level of 6 cm H2O; ZEEP: with zero end expiratory pressure; PEEP 6 + CACC: with a PEEP level of 6 cm H2O and a concomitant continuous anterior chest compression by the mean of a positive pressure of 80 cm H2O applied on the anterior chest wall. Paw: airway pressure waveform; ΔEELV: variation of end expiratory lung volume as compared to the “PEEP 6” condition; Pplat: plateau pressure; ΔP: driving pressure defined as the difference between plateau pressure and total PEEP; CRS: respiratory system compliance; Clung: lung compliance; PLend-insp: transpulmonary pressure at end inspiration, computed as follows: PLend-insp = Pplat x (EL/Ers) where EL is the lung elastance and Ers the respiratory system elastance [5]; PLend-exp: transpulmonary pressure at end expiration, computed as follows: PLend-exp = PEEPt – PESend-exp where PEEPt is the total PEEP and PESend-exp is the end expiratory esophageal pressure value; the chest CT-scan retrieved posterior consolidations with diffuse ground glass opacities, reticulations, and traction bronchiectasis suggestive of a fibrotic evolution; EIT: electrical impedance tomography (Enlight 1800, Timpel, Sao Paulo, Brazil); A/P: percentage of variation in impedance during ventilation (ΔZ) in the anterior (A) and posterior (P) half of the lung; R/L: percentage of variation in impedance during ventilation (ΔZ) in the right (R) and left (L) half of the lung; Clung-ant: regional lung compliance in the anterior (ventral) half of the lung; Clung-post: regional lung compliance in the posterior (dorsal) half of the lung
Fig. 2
Fig. 2
Elastic pressure–volume curve. Elastic pressure–volume curve was obtained by performing a low-flow (4 L/min) inflation up to 35 cm H2O of airway pressure in three different conditions: PEEP 6: with a PEEP level of 6 cm H2O; ZEEP: with zero end expiratory pressure; PEEP 6 + CACC: with a PEEP level of 6 cm H2O and a concomitant continuous anterior chest compression by the mean of a positive pressure of 80 cm H2O applied on the anterior chest wall
See this image and copyright information in PMC

References

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