TY -的T1 alveo的非侵入性的测定lar pressure during mechanical ventilation JF - European Respiratory Journal JO - Eur Respir J SP - 1275 LP - 1283 VL - 4 IS - 10 AU - Nicolai, T AU - Lanteri, C AU - Freezer, N AU - Sly, PD Y1 - 1991/11/01 UR - //www.qdcxjkg.com/content/4/10/1275.abstract N2 - The development of inadvertent positive end-expiratory pressure (PEEPi) in ventilated infants is of clinical relevance and difficult to measure non-invasively. A method for estimating end-expiratory alveolar pressure by applying a multiple regression analysis to airway opening pressure, flow and volume recordings during mechanical ventilation was evaluated. In eight open-chested, paralysed and mechanically ventilated mongrel dogs, alveolar pressure was measured directly with "alveolar capsules". Alteration of ventilation patterns and addition of a resistive element were used in three dogs to induce different levels of PEEPi. End-expiratory alveolar pressure measured directly and determined from multilinear regression of airway opening pressure correlated well (mean error 0.06 +/- 0.53 (+/- SD) hPa, limits of agreement -1.16 to +1.04 hPa). The other five dogs received inhalation challenges, two with histamine, two with hypertonic saline and one with methacholine resulting in a mean increase of respiratory system resistance of 230% (range 141-489%) of the baseline values. The mean error in determining PEEPi was 0.54 +/- 0.37 hPa, the limits of agreement were -0.20 to 1.28 hPa. The method was then applied to seven mechanically-ventilated children (aged 2 months to 8 yrs, weight 4.9-23.5 kg) and the results were compared to the pressure at which inspiration began (equalling PEEPi). Seventy eight measurements were performed during open heart surgery, while compliance changed by between 3 and 186% of baseline values due to the surgical procedures. PEEPi estimated by multiple regression agreed well with the pressure at which inspiration began (mean difference 0.25 +/- 0.68 hPa, limits of agreement -1.12 to 1.62 hPa).(ABSTRACT TRUNCATED AT 250 WORDS) ER -