Airway resistance and respiratory compliance in children with acute viral bronchiolitis requiring mechanical ventilation support

Detalhes bibliográficos
Autor(a) principal: Andreolio, Cinara
Data de Publicação: 2021
Outros Autores: Piva, Jefferson Pedro, Bruno, Francisco, Rocha, Tais Sica da, Garcia, Pedro Celiny Ramos
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFRGS
Texto Completo: http://hdl.handle.net/10183/243258
Resumo: Background: Acute viral bronchiolitis (AVB) is a very frequent disease that affects the lower airways of young children increasing the inspiratory and expiratory resistance in variable degree as well as reducing the pulmonary compliance. It would be desirable to know whether these variables are associated with the outcome. Objectives: To evaluate the respiratory mechanics in infants with AVB requiring mechanical ventilation (MV) support and to evaluate if respiratory mechanics predict outcomes in children with AVB supported on MV. To evaluate the respiratory mechanics in infants with AVB submitted to MV. Materials and methods: A prospective observational study was conducted in two pediatric intensive care units (PICUs) between February 2016 and March 2017. Included were infants (1 month to 1 year old) admitted with AVB and requiring MV for >48 hours. Auto-PEEP, dynamic compliance (Cdyn), static compliance (Cstat), expiratory resistance (ExRes), and inspiratory resistance (InRes) were evaluated once daily on the second and third day of MV. Results: A total of 64 infants (median age of 2.8 months and a mean weight of 4.8 ± 1.7 kg) were evaluated. A mean positive inspiratory pressure (PIP) of 31.5 ± 5.2 cmH2O, positive end-expiratory pressure (PEEP) of 5.5 ± 1.4 cmH2O, resulting in a mean airway pressure (MAP) of 12.5 ± 2.2 cmH2O and delta pressure of 22.5 ± 4.4 cmH2O without difference between the two hospitals. Measurements of respiratory mechanics showed high values of InRes and ExRes (median 142 [IQ25–75 106–180] cmH2O/L/s and 158 [IQ25–75 130–195.3] cmH2O/L/s, respectively), accompanied by decreased Cdyn and Cstat (0.46 ± 0.19 and 0.81 ± 0.25 mL/kg/cmH2O, respectively). None of the variables was associated with mortality, length of MV, or length of PICU stay. Conclusion: Infants with AVB requiring MV support present very high InRes and ExRes values. These findings might be the reason for the aggressive ventilatory parameters, especially PIP, required to ventilate this group of children with lower airway obstruction. Clinical significance: Monitoring respiratory mechanics could represent a useful tool to guide the ventilatory strategy to be adopted in patients with AVB.
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spelling Andreolio, CinaraPiva, Jefferson PedroBruno, FranciscoRocha, Tais Sica daGarcia, Pedro Celiny Ramos2022-07-20T04:49:51Z20211998-359Xhttp://hdl.handle.net/10183/243258001144723Background: Acute viral bronchiolitis (AVB) is a very frequent disease that affects the lower airways of young children increasing the inspiratory and expiratory resistance in variable degree as well as reducing the pulmonary compliance. It would be desirable to know whether these variables are associated with the outcome. Objectives: To evaluate the respiratory mechanics in infants with AVB requiring mechanical ventilation (MV) support and to evaluate if respiratory mechanics predict outcomes in children with AVB supported on MV. To evaluate the respiratory mechanics in infants with AVB submitted to MV. Materials and methods: A prospective observational study was conducted in two pediatric intensive care units (PICUs) between February 2016 and March 2017. Included were infants (1 month to 1 year old) admitted with AVB and requiring MV for >48 hours. Auto-PEEP, dynamic compliance (Cdyn), static compliance (Cstat), expiratory resistance (ExRes), and inspiratory resistance (InRes) were evaluated once daily on the second and third day of MV. Results: A total of 64 infants (median age of 2.8 months and a mean weight of 4.8 ± 1.7 kg) were evaluated. A mean positive inspiratory pressure (PIP) of 31.5 ± 5.2 cmH2O, positive end-expiratory pressure (PEEP) of 5.5 ± 1.4 cmH2O, resulting in a mean airway pressure (MAP) of 12.5 ± 2.2 cmH2O and delta pressure of 22.5 ± 4.4 cmH2O without difference between the two hospitals. Measurements of respiratory mechanics showed high values of InRes and ExRes (median 142 [IQ25–75 106–180] cmH2O/L/s and 158 [IQ25–75 130–195.3] cmH2O/L/s, respectively), accompanied by decreased Cdyn and Cstat (0.46 ± 0.19 and 0.81 ± 0.25 mL/kg/cmH2O, respectively). None of the variables was associated with mortality, length of MV, or length of PICU stay. Conclusion: Infants with AVB requiring MV support present very high InRes and ExRes values. These findings might be the reason for the aggressive ventilatory parameters, especially PIP, required to ventilate this group of children with lower airway obstruction. Clinical significance: Monitoring respiratory mechanics could represent a useful tool to guide the ventilatory strategy to be adopted in patients with AVB.application/pdfengIndian journal of critical care medicine. New Dehli. Vol. 25, no. 1 (Jan. 2021), p. 88-93.Resistência das vias respiratóriasBronquioliteRespiração artificialCriançaAirway resistanceLung complianceMechanical ventilationPediatricsViral bronchiolitisAirway resistance and respiratory compliance in children with acute viral bronchiolitis requiring mechanical ventilation supportEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001144723.pdf.txt001144723.pdf.txtExtracted Texttext/plain34355http://www.lume.ufrgs.br/bitstream/10183/243258/2/001144723.pdf.txta4e76e6555e133dcd9d2651f5eccdc8cMD52ORIGINAL001144723.pdfTexto completo (inglês)application/pdf565260http://www.lume.ufrgs.br/bitstream/10183/243258/1/001144723.pdf97ff790e2097ab924efd24de1ff3f953MD5110183/2432582022-07-21 04:56:57.541723oai:www.lume.ufrgs.br:10183/243258Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2022-07-21T07:56:57Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false
dc.title.pt_BR.fl_str_mv Airway resistance and respiratory compliance in children with acute viral bronchiolitis requiring mechanical ventilation support
title Airway resistance and respiratory compliance in children with acute viral bronchiolitis requiring mechanical ventilation support
spellingShingle Airway resistance and respiratory compliance in children with acute viral bronchiolitis requiring mechanical ventilation support
Andreolio, Cinara
Resistência das vias respiratórias
Bronquiolite
Respiração artificial
Criança
Airway resistance
Lung compliance
Mechanical ventilation
Pediatrics
Viral bronchiolitis
title_short Airway resistance and respiratory compliance in children with acute viral bronchiolitis requiring mechanical ventilation support
title_full Airway resistance and respiratory compliance in children with acute viral bronchiolitis requiring mechanical ventilation support
title_fullStr Airway resistance and respiratory compliance in children with acute viral bronchiolitis requiring mechanical ventilation support
title_full_unstemmed Airway resistance and respiratory compliance in children with acute viral bronchiolitis requiring mechanical ventilation support
title_sort Airway resistance and respiratory compliance in children with acute viral bronchiolitis requiring mechanical ventilation support
author Andreolio, Cinara
author_facet Andreolio, Cinara
Piva, Jefferson Pedro
Bruno, Francisco
Rocha, Tais Sica da
Garcia, Pedro Celiny Ramos
author_role author
author2 Piva, Jefferson Pedro
Bruno, Francisco
Rocha, Tais Sica da
Garcia, Pedro Celiny Ramos
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Andreolio, Cinara
Piva, Jefferson Pedro
Bruno, Francisco
Rocha, Tais Sica da
Garcia, Pedro Celiny Ramos
dc.subject.por.fl_str_mv Resistência das vias respiratórias
Bronquiolite
Respiração artificial
Criança
topic Resistência das vias respiratórias
Bronquiolite
Respiração artificial
Criança
Airway resistance
Lung compliance
Mechanical ventilation
Pediatrics
Viral bronchiolitis
dc.subject.eng.fl_str_mv Airway resistance
Lung compliance
Mechanical ventilation
Pediatrics
Viral bronchiolitis
description Background: Acute viral bronchiolitis (AVB) is a very frequent disease that affects the lower airways of young children increasing the inspiratory and expiratory resistance in variable degree as well as reducing the pulmonary compliance. It would be desirable to know whether these variables are associated with the outcome. Objectives: To evaluate the respiratory mechanics in infants with AVB requiring mechanical ventilation (MV) support and to evaluate if respiratory mechanics predict outcomes in children with AVB supported on MV. To evaluate the respiratory mechanics in infants with AVB submitted to MV. Materials and methods: A prospective observational study was conducted in two pediatric intensive care units (PICUs) between February 2016 and March 2017. Included were infants (1 month to 1 year old) admitted with AVB and requiring MV for >48 hours. Auto-PEEP, dynamic compliance (Cdyn), static compliance (Cstat), expiratory resistance (ExRes), and inspiratory resistance (InRes) were evaluated once daily on the second and third day of MV. Results: A total of 64 infants (median age of 2.8 months and a mean weight of 4.8 ± 1.7 kg) were evaluated. A mean positive inspiratory pressure (PIP) of 31.5 ± 5.2 cmH2O, positive end-expiratory pressure (PEEP) of 5.5 ± 1.4 cmH2O, resulting in a mean airway pressure (MAP) of 12.5 ± 2.2 cmH2O and delta pressure of 22.5 ± 4.4 cmH2O without difference between the two hospitals. Measurements of respiratory mechanics showed high values of InRes and ExRes (median 142 [IQ25–75 106–180] cmH2O/L/s and 158 [IQ25–75 130–195.3] cmH2O/L/s, respectively), accompanied by decreased Cdyn and Cstat (0.46 ± 0.19 and 0.81 ± 0.25 mL/kg/cmH2O, respectively). None of the variables was associated with mortality, length of MV, or length of PICU stay. Conclusion: Infants with AVB requiring MV support present very high InRes and ExRes values. These findings might be the reason for the aggressive ventilatory parameters, especially PIP, required to ventilate this group of children with lower airway obstruction. Clinical significance: Monitoring respiratory mechanics could represent a useful tool to guide the ventilatory strategy to be adopted in patients with AVB.
publishDate 2021
dc.date.issued.fl_str_mv 2021
dc.date.accessioned.fl_str_mv 2022-07-20T04:49:51Z
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dc.identifier.issn.pt_BR.fl_str_mv 1998-359X
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dc.relation.ispartof.pt_BR.fl_str_mv Indian journal of critical care medicine. New Dehli. Vol. 25, no. 1 (Jan. 2021), p. 88-93.
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