Activation of Automatic Tube Compensation Mode Attenuates Auto-PEEP in Chronic Obstructive Pulmonary Disease Patients

IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Clinical Respiratory Journal Pub Date : 2024-10-22 DOI:10.1111/crj.70028
Omid Moradi Moghaddam, Shahab Mohammadi, Mohsen Sedighi, Alireza Amanollahi, Behrooz Zaman, Mahzad Alimian, Mansoor Soltani, Mohammad Niakan Lahiji
{"title":"Activation of Automatic Tube Compensation Mode Attenuates Auto-PEEP in Chronic Obstructive Pulmonary Disease Patients","authors":"Omid Moradi Moghaddam,&nbsp;Shahab Mohammadi,&nbsp;Mohsen Sedighi,&nbsp;Alireza Amanollahi,&nbsp;Behrooz Zaman,&nbsp;Mahzad Alimian,&nbsp;Mansoor Soltani,&nbsp;Mohammad Niakan Lahiji","doi":"10.1111/crj.70028","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Dynamic hyperinflation in chronic obstructive pulmonary disease (COPD) results in intrinsic positive end-expiratory pressure (auto-PEEP). Automatic tube compensation (ATC) is used to increase airway pressure in COPD and overcome endotracheal tube (ETT)–imposed respiratory workload. We aim to investigate effects of ATC activation on auto-PEEP decrease in COPD.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>ATC was activated three times a day (1 min duration) in the morning, evening, and night shift. Auto-PEEP was measured for the 1 min period (every 6 s) following ATC activation. Linear mixed model (LMM) was used to measure changes in auto-PEEP and compare with baseline value. Age, gender, and COPD types were inserted in model as covariates and analyzed using SPSS.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 60 patients including COPD (<i>n</i> = 40) and COPD with exacerbation (<i>n</i> = 20) were included. Compared with exacerbated COPD, baseline auto-PEEP in COPD was significantly lower in morning (<i>p</i> = 0.011), evening (<i>p</i> = 0.043), and night shift (<i>p</i> = 0.007). After ATC activation, auto-PEEP decreased significantly in COPD in morning, evening, and night (<i>p</i> = 0.001), but magnitude of this decrease was notably larger in COPD than in exacerbated COPD (<i>p</i> = 0.001). Moreover, there was a significant relationship between COPD exacerbation and changes in auto-PEEP in morning (<i>β</i> = −0.27, <i>p</i> = 0.001), evening (<i>β</i> = −0.16, <i>p</i> = 0.001), and night (<i>β</i> = −0.26, <i>p</i> = 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The activation of ATC mode in COPD patients under mechanical ventilation could decrease the value of auto-PEEP. Nevertheless, COPD patients with an exacerbation appear to benefit less from ATC activation.</p>\n </section>\n </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 10","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495854/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Respiratory Journal","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/crj.70028","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction

Dynamic hyperinflation in chronic obstructive pulmonary disease (COPD) results in intrinsic positive end-expiratory pressure (auto-PEEP). Automatic tube compensation (ATC) is used to increase airway pressure in COPD and overcome endotracheal tube (ETT)–imposed respiratory workload. We aim to investigate effects of ATC activation on auto-PEEP decrease in COPD.

Methods

ATC was activated three times a day (1 min duration) in the morning, evening, and night shift. Auto-PEEP was measured for the 1 min period (every 6 s) following ATC activation. Linear mixed model (LMM) was used to measure changes in auto-PEEP and compare with baseline value. Age, gender, and COPD types were inserted in model as covariates and analyzed using SPSS.

Results

A total of 60 patients including COPD (n = 40) and COPD with exacerbation (n = 20) were included. Compared with exacerbated COPD, baseline auto-PEEP in COPD was significantly lower in morning (p = 0.011), evening (p = 0.043), and night shift (p = 0.007). After ATC activation, auto-PEEP decreased significantly in COPD in morning, evening, and night (p = 0.001), but magnitude of this decrease was notably larger in COPD than in exacerbated COPD (p = 0.001). Moreover, there was a significant relationship between COPD exacerbation and changes in auto-PEEP in morning (β = −0.27, p = 0.001), evening (β = −0.16, p = 0.001), and night (β = −0.26, p = 0.001).

Conclusion

The activation of ATC mode in COPD patients under mechanical ventilation could decrease the value of auto-PEEP. Nevertheless, COPD patients with an exacerbation appear to benefit less from ATC activation.

Abstract Image

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
激活自动导管补偿模式可减轻慢性阻塞性肺病患者的自动早搏。
简介:慢性阻塞性肺病(COPD)的动态过度充气会导致内在呼气末正压(auto-PEEP)。自动导管补偿(ATC)用于增加慢性阻塞性肺病患者的气道压力,克服气管导管(ETT)造成的呼吸负荷。我们的目的是研究 ATC 激活对慢性阻塞性肺病患者自动气道压力下降的影响:方法:每天早班、晚班和夜班三次启动 ATC(持续时间为 1 分钟)。在 ATC 启动后的 1 分钟内(每 6 秒)测量自动肺活量。采用线性混合模型(LMM)来测量自动肺活量的变化,并与基线值进行比较。将年龄、性别和慢性阻塞性肺病类型作为协变量加入模型,并使用 SPSS 进行分析:结果:共纳入 60 名患者,包括慢性阻塞性肺疾病(40 人)和慢性阻塞性肺疾病加重(20 人)。与病情加重的慢性阻塞性肺病患者相比,慢性阻塞性肺病患者的基线自动肺活量在早班(p = 0.011)、晚班(p = 0.043)和夜班(p = 0.007)明显较低。激活 ATC 后,慢性阻塞性肺病患者在早、晚和夜班时的自动肺活量明显下降(p = 0.001),但慢性阻塞性肺病患者的下降幅度明显大于慢性阻塞性肺病加重患者(p = 0.001)。此外,慢性阻塞性肺病加重与自动肺活量变化之间存在明显的关系:早晨(β = -0.27,p = 0.001)、傍晚(β = -0.16,p = 0.001)和夜间(β = -0.26,p = 0.001):结论:接受机械通气的慢性阻塞性肺病患者启动 ATC 模式会降低自动肺活量(auto-PEEP)的值。然而,病情加重的慢性阻塞性肺病患者似乎从 ATC 激活中获益较少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Clinical Respiratory Journal
Clinical Respiratory Journal 医学-呼吸系统
CiteScore
3.70
自引率
0.00%
发文量
104
审稿时长
>12 weeks
期刊介绍: Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)
期刊最新文献
Highly Sensitive and Specific Panels of Plasma Exosomal microRNAs for Identification of Malignant Pulmonary Nodules A Novel Scale for Diagnosis of Pulmonary Ground-Glass Nodules: A Multicenter and Ambispective Cohort Study Prognostic Nomogram for Predicting Survival in Asian Patients With Small-Cell Lung Cancer: A Comprehensive Population-Based Study and External Verification Ergotamine Targets KIF5A to Facilitate Anoikis in Lung Adenocarcinoma IGF2BP3/CTCF Axis–Dependent NT5DC2 Promotes M2 Macrophage Polarization to Enhance the Malignant Progression of Lung Squamous Cell Carcinomas
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1