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Research ArticleOriginal Research

Agreement Between Functional Residual Capacity Estimated via Automated Gas Dilution Versus via Computed Tomography in a Pleural Effusion Model

Jeronimo Graf, Arnoldo Santos, David Dries, Alexander B Adams and John J Marini
Respiratory Care November 2010, 55 (11) 1464-1468;
Jeronimo Graf
Department of Pulmonary Research
Unidad de Cuidados Intensivos Adultos, Clinica Alemana de Santiago, Santiago, Chile.
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Arnoldo Santos
Department of Pulmonary/Critical Care
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David Dries
Department of Surgery, Regions Hospital, St Paul, Minnesota.
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Alexander B Adams
Department of Pulmonary Research
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  • For correspondence: [email protected]
John J Marini
Department of Pulmonary/Critical Care
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Abstract

BACKGROUND: The measurement of functional residual capacity (FRC) in ventilated patients could help track the extent of acute lung disease, monitor recruitment of unstable lung units, or guide the use of PEEP. Quantitative analysis of computed tomography (CT) images of the lungs is currently the accepted standard for FRC measurement (FRC-CT), but is impractical for routine use. Gas dilution and gas tracer technologies, while attractive for research applications, require specialized equipment and skills missing from the clinical setting. We simultaneously evaluated FRC-CT and FRC determined by a ventilator-incorporated wash-in/wash-out (FRC-WI/WO) method in an animal model of unilateral pleural effusion that varied the fluid volume instilled and the applied PEEP.

METHODS: A swine model (n = 6) of unilateral pleural effusion was created by injecting boluses of radio-opaque fluid (iopromide) (13 mL/kg and then 26 mL/kg) into the right thoracic cavity. FRC-CT and FRC-WI/WO were simultaneously obtained, at 2 PEEP levels, at baseline and at both pleural-effusion volumes.

RESULTS: A correlation coefficient (r2) of 0.89 between FRC-CT and FRC-WI/WO revealed concordance between the techniques, with directional agreement and acceptable bias and precision under all tested conditions.

CONCLUSIONS: We found excellent concordance between FRC-WI/WO and FRC-CT in an animal model of unilateral pleural effusion that stressed the capability of this technology. The technical advantage of the wash-in/wash-out technique is its incorporation into ventilator operation without requiring adjustments to ventilation.

  • functional residual capacity
  • mechanical ventilation
  • pleural effusion
  • monitoring
  • chest mechanics

Footnotes

  • Correspondence: Alexander B Adams MPH RRT FAARC, Department of Pulmonary Research, Regions Hospital, 640 Jackson Street, St Paul MN 55101. E-mail: alex.b.adams{at}healthpartners.com.
  • This study was partly supported by GE Healthcare and HealthPartners Research Foundation. The ventilators were provided by GE Healthcare. The study was designed solely by the authors. GE Healthcare did not authorize publication of these results. The authors have disclosed no other conflicts of interest.

  • Mr Adams presented a version of this paper at the Open Forum at the 55th International Respiratory Congress of the American Association for Respiratory Care, held December 5–8, 2009, in San Antonio, Texas.

  • Copyright © 2010 by Daedalus Enterprises Inc.
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Respiratory Care: 55 (11)
Respiratory Care
Vol. 55, Issue 11
1 Nov 2010
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Agreement Between Functional Residual Capacity Estimated via Automated Gas Dilution Versus via Computed Tomography in a Pleural Effusion Model
Jeronimo Graf, Arnoldo Santos, David Dries, Alexander B Adams, John J Marini
Respiratory Care Nov 2010, 55 (11) 1464-1468;

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Agreement Between Functional Residual Capacity Estimated via Automated Gas Dilution Versus via Computed Tomography in a Pleural Effusion Model
Jeronimo Graf, Arnoldo Santos, David Dries, Alexander B Adams, John J Marini
Respiratory Care Nov 2010, 55 (11) 1464-1468;
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Keywords

  • functional residual capacity
  • mechanical ventilation
  • pleural effusion
  • monitoring
  • chest mechanics

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