Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg-University, 55131 Mainz, Germany.
Physiol Meas. 2011 May;32(5):571-83. doi: 10.1088/0967-3334/32/5/006. Epub 2011 Apr 1.
The forced oscillation technique (FOT) allows the measurement of respiratory mechanics in the intensive care setting. The aim of this study was to compare the FOT with a reference method during mechanical ventilation through a tracheal tube. The respiratory impedance spectra were measured by FOT in nine anaesthetized pigs, and resistance and compliance were estimated on the basis of a linear resistance-compliance inertance model. In comparison, resistance and compliance were quantified by the multiple linear regression analysis (LSF) of conventional ventilator waveforms to the equation of motion. The resistance of the sample was found to range from 6 to 21 cmH(2)O s l(-1) and the compliance from 12 to 32 ml cmH(2)O(-1). A Bland-Altman analysis of the resistance resulted in a sufficient agreement (bias -0.4 cmH(2)O s l(-1); standard deviation of differences 1.4 cmH(2)O s l(-1); correlation coefficient 0.93) and test-retest reliability (coefficient of variation of repeated measurements: FOT 2.1%; LSF 1.9%). The compliance, however, was poor in agreement (bias -8 ml cmH(2)O(-1), standard deviation of differences 7 ml cmH(2)O(-1), correlation coefficient 0.74) and repeatability (coefficient of variation: FOT 23%; LSF 1.7%). In conclusion, FOT provides an alternative for monitoring resistance, but not compliance, in tracheally intubated and ventilated subjects.
强迫振荡技术(FOT)允许在重症监护环境中测量呼吸力学。本研究的目的是比较 FOT 与机械通气时通过气管内管的参考方法。通过 FOT 在 9 只麻醉猪中测量呼吸阻抗谱,并基于线性阻力-顺应性惯性模型估计阻力和顺应性。相比之下,通过对常规呼吸机波形进行多元线性回归分析(LSF)到运动方程来量化阻力和顺应性。样品的阻力范围为 6 至 21 cmH(2)O s l(-1),顺应性为 12 至 32 ml cmH(2)O(-1)。FOT 测量的阻力的 Bland-Altman 分析显示出足够的一致性(偏差为 -0.4 cmH(2)O s l(-1);差异的标准差为 1.4 cmH(2)O s l(-1);相关系数为 0.93)和测试-重测可靠性(重复测量的变异系数:FOT 为 2.1%;LSF 为 1.9%)。然而,顺应性的一致性较差(偏差为 -8 ml cmH(2)O(-1),差异的标准差为 7 ml cmH(2)O(-1),相关系数为 0.74)和重复性(变异系数:FOT 为 23%;LSF 为 1.7%)。总之,FOT 为气管插管和通气患者的阻力监测提供了一种替代方法,但不能监测顺应性。