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Observational Study
. 2023 Oct 1;51(10):e201-e205.
doi: 10.1097/CCM.0000000000005964. Epub 2023 Jun 16.

Reliability of Respiratory System Compliance Calculation During Assisted Mechanical Ventilation: A Retrospective Study

Luca Bastia  1 , Liliana Amendolagine  2 , Federico Pozzi  1 , Stefano Carenini  1 , Cristiana Cipolla  1 , Francesco Curto  1 , Giacomo Bellani  3   4 , Roberto Fumagalli  2   5 , Arturo Chieregato  1
Affiliations
Observational Study

Reliability of Respiratory System Compliance Calculation During Assisted Mechanical Ventilation: A Retrospective Study

Luca Bastia et al. Crit Care Med. .

Abstract

Objectives: To compare respiratory system compliance (C rs ) calculation during controlled mechanical ventilation (MV) and, subsequently, during assisted MV.

Design: This is a single-center, retrospective, observational study.

Setting: This study was conducted on patients admitted to Neuro-ICU of Niguarda Hospital (tertiary referral hospital).

Patients: We analyzed every patient greater than or equal to 18 years old having a C rs measurement in controlled and in assisted MV within 60 minutes. Plateau pressure (P plat ) was considered reliable if it was deemed visually stable for at least 2 seconds.

Interventions: Inspiratory pause was incorporated to detect P plat in controlled and assisted MV. Calculation of C rs and driving pressure were achieved.

Measurements and main results: A total of 101 patients were studied. An acceptable agreement was found (Bland-Altman plot bias -3.9, level of agreement upper 21.6, lower -29.6). C rs in assisted MV was 64.1 (52.6-79.3) and in controlled MV it was 61.2 (50-71.2) mL/cm H 2o ( p = 0.006). No statistical difference was found in C rs (assisted vs controlled MV) when peak pressure was lower than P plat nor when peak pressure was higher than P plat .

Conclusions: A P plat visually stable for at least 2 seconds leads to reliable C rs calculation during assisted MV.

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Conflict of interest statement

Dr. Fumagalli disclosed work for hire. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Comment in

References

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