Abstract
During CPPB with severe airway obstruction end-expiratory occlusion pressure may exceed applied PEEP (autopeep). Alveolar pressure may then exceed airway pressure throughout expiration. This study examined the relationship of mean airway (PAW) and alveolar (PALV) pressures in the presence of “autopeep”.
5 piglets (1-4kg) and 2 lambs (4-5kg) were ventilated with endotracheal tubes obstructed at the hub to an orifice of 1.5 mm. Alveolar pressure was estimated by repeatedly occluding the airway at times in the respiratory cycle that varied from trial to trial. Real time curves were reconstructed using occlusion time, proximal airway pressure and plateau occlusion pressure. PAW and PALV were estimated by integration of real time curves generated for inspiratory times (I) of 25% and 80% at levels of PEEP from 0 to 12 mmHg.
Long I generated autopeep and, for any PEEP applied, increased both PAW and PALV. PAW remained an excellent predictor of PALV in spite of autopeep.
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Venkataraman, S., Orr, P., Howland, D. et al. SEVERE AIRWAY OBSTRUCTION: AIRMY AND ALVEOLAR PRESSURES DURING CONTINUOUS POSITIVE PRESSURE BREATHING (CPPB). Pediatr Res 21 (Suppl 4), 207 (1987). https://doi.org/10.1203/00006450-198704010-00248
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DOI: https://doi.org/10.1203/00006450-198704010-00248