Effects of a Sigh on the Respiratory Mechanical Pr

Authors: Vittorio Antonaglia Sara Pascotto Loredana De Simoni Walter A Zin

Publish Date: 2006/06/21

Volume: 20, Issue: 4, Pages: 243-249

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Abstract

Objectives The application of sighs during baseline ventilation was found to improve alveolar recruitment and oxygenation in patients with acute respiratory distress syndrome ARDS The present investigation evaluates if respiratory mechanics can be modified by a sigh Methods Ten consecutive patients with acute lung injury ALI admitted to the University Hospital Intensive Care Unit the were studied during mechanical ventilation Three sighs were administered to sedatedparalyzed patients during the measurement period Respiratory mechanics were studied in regular breaths immediately before and after a sigh provided that a steadystate had been reached and by the airway pressuretime curve profile to evaluate the lung recruitment Viscoelastic constants elastic resistive and time as well as elastance and resistances were determined by the single breath method Arterial blood gases were also determined pre and postsigh Results Elastic and resistive components of viscoelasticity decreased after a sigh 20 and 21 respectively As a result the pressure required to overcome viscoelasticity and mechanical inhomogeneities also decreased in these patients 17 The mechanical changes were associated with alterations in PaO2 Conclusions The sigh is useful to diminish viscoelastic impedance in ALI patients thus allowing a smaller inflation pressure Under the present experimental conditions it seems that viscoelastic mechanical alterations precede their elastic and resistive counterparts

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