Clinical application of respiratory elastance (CARE trial) for mechanically ventilated respiratory failure patients: a model-based study

Clinical application of respiratory elastance (CARE trial) for mechanically ventilated respiratory failure patients: a model-based study

Mechanical ventilation (MV) is the primary support for respiratory failure patients. MV treatment is difficult to manage due to the variable patient-specific disease state and response to MV treatment. Model-based methods have shown potential in providing unique, personalised information on patient...

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Main Authors: Chiew, Yeong Shiong, Chase, J. Geoffrey, Arunachalam, Ganesaramachandran, Tan, Chee Pin, Loo, Nienloong, Chiew, Yeongwoei, Md Ralib, Azrina, Mat Nor, Mohd Basri
Format: Article
Language:English
English
Published: IFAC Secretariat 2018
Subjects:
RC Internal medicine
RC731 Specialties of Internal Medicine-Diseases of The Respiratory System
Online Access:http://irep.iium.edu.my/70221/
http://irep.iium.edu.my/70221/
http://irep.iium.edu.my/70221/
http://irep.iium.edu.my/70221/1/70221_Clinical%20Application%20of%20Respiratory%20Elastance%20%28CARE%20Trial%29_article.pdf
http://irep.iium.edu.my/70221/2/70221_Clinical%20Application%20of%20Respiratory%20Elastance%20%28CARE%20Trial%29_scopus.pdf
id iium-70221
recordtype eprints
spelling iium-702212019-03-13T03:05:11Z http://irep.iium.edu.my/70221/ Clinical application of respiratory elastance (CARE trial) for mechanically ventilated respiratory failure patients: a model-based study Chiew, Yeong Shiong Chase, J. Geoffrey Arunachalam, Ganesaramachandran Tan, Chee Pin Loo, Nienloong Chiew, Yeongwoei Md Ralib, Azrina Mat Nor, Mohd Basri RC Internal medicine RC731 Specialties of Internal Medicine-Diseases of The Respiratory System Mechanical ventilation (MV) is the primary support for respiratory failure patients. MV treatment is difficult to manage due to the variable patient-specific disease state and response to MV treatment. Model-based methods have shown potential in providing unique, personalised information on patient condition for clinicians to guide MV treatment. This study presents a clinical observational trial to investigate the respiratory mechanics and quality of patient ventilator asynchrony conducted in a South-East Asia hospital intensive care unit (ICU). Pilot trial results included 7 study patients. Patient-specific respiratory mechanics Ers and Rrs were median 32.30 cmH2O/l [Interquartile range (IQR): 24.53-43.48] and 7.62 cmH2Os/l [IQR: 4.85-10.34]. The Normalised Area Under the Curve of Time-Varying Elastance (AUC-Edrs) across patients were 27.50 cmH2O/l [IQR: 24.97-28.34]. Patient ventilator interaction is assessed using an asynchrony index (AI), where AI had a median value of 27.0% [(IQR): 21.0-52.7]. Patient-specific respiratory mechanics displayed intra- and inter- patient variability, suggesting patients are different and evolved over time, and thus their MV settings should be patient-specific and time-varying. Model-based methods thus offer unique insight into patient-specific respiratory mechanics and the resulting opportunity to personalize and optimise MV based on evolving patient-specific needs. IFAC Secretariat 2018 Article NonPeerReviewed application/pdf en http://irep.iium.edu.my/70221/1/70221_Clinical%20Application%20of%20Respiratory%20Elastance%20%28CARE%20Trial%29_article.pdf application/pdf en http://irep.iium.edu.my/70221/2/70221_Clinical%20Application%20of%20Respiratory%20Elastance%20%28CARE%20Trial%29_scopus.pdf Chiew, Yeong Shiong and Chase, J. Geoffrey and Arunachalam, Ganesaramachandran and Tan, Chee Pin and Loo, Nienloong and Chiew, Yeongwoei and Md Ralib, Azrina and Mat Nor, Mohd Basri (2018) Clinical application of respiratory elastance (CARE trial) for mechanically ventilated respiratory failure patients: a model-based study. IFAC-PapersOnLine, 51 (27). pp. 209-214. ISSN 2405-8963 https://reader.elsevier.com/reader/sd/pii/S2405896318333573?token=C4CD13051CD1110A46D5AFCEAEE9E989328A5A1A4A7F550EFD8F521EC8D3E568B494FBF5112BC5C6C918722C718277D6 10.1016/j.ifacol.2018.11.641
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
English
topic RC Internal medicine
RC731 Specialties of Internal Medicine-Diseases of The Respiratory System
spellingShingle RC Internal medicine
RC731 Specialties of Internal Medicine-Diseases of The Respiratory System
Chiew, Yeong Shiong
Chase, J. Geoffrey
Arunachalam, Ganesaramachandran
Tan, Chee Pin
Loo, Nienloong
Chiew, Yeongwoei
Md Ralib, Azrina
Mat Nor, Mohd Basri
Clinical application of respiratory elastance (CARE trial) for mechanically ventilated respiratory failure patients: a model-based study
description Mechanical ventilation (MV) is the primary support for respiratory failure patients. MV treatment is difficult to manage due to the variable patient-specific disease state and response to MV treatment. Model-based methods have shown potential in providing unique, personalised information on patient condition for clinicians to guide MV treatment. This study presents a clinical observational trial to investigate the respiratory mechanics and quality of patient ventilator asynchrony conducted in a South-East Asia hospital intensive care unit (ICU). Pilot trial results included 7 study patients. Patient-specific respiratory mechanics Ers and Rrs were median 32.30 cmH2O/l [Interquartile range (IQR): 24.53-43.48] and 7.62 cmH2Os/l [IQR: 4.85-10.34]. The Normalised Area Under the Curve of Time-Varying Elastance (AUC-Edrs) across patients were 27.50 cmH2O/l [IQR: 24.97-28.34]. Patient ventilator interaction is assessed using an asynchrony index (AI), where AI had a median value of 27.0% [(IQR): 21.0-52.7]. Patient-specific respiratory mechanics displayed intra- and inter- patient variability, suggesting patients are different and evolved over time, and thus their MV settings should be patient-specific and time-varying. Model-based methods thus offer unique insight into patient-specific respiratory mechanics and the resulting opportunity to personalize and optimise MV based on evolving patient-specific needs.
format Article
author Chiew, Yeong Shiong
Chase, J. Geoffrey
Arunachalam, Ganesaramachandran
Tan, Chee Pin
Loo, Nienloong
Chiew, Yeongwoei
Md Ralib, Azrina
Mat Nor, Mohd Basri
author_facet Chiew, Yeong Shiong
Chase, J. Geoffrey
Arunachalam, Ganesaramachandran
Tan, Chee Pin
Loo, Nienloong
Chiew, Yeongwoei
Md Ralib, Azrina
Mat Nor, Mohd Basri
author_sort Chiew, Yeong Shiong
title Clinical application of respiratory elastance (CARE trial) for mechanically ventilated respiratory failure patients: a model-based study
title_short Clinical application of respiratory elastance (CARE trial) for mechanically ventilated respiratory failure patients: a model-based study
title_full Clinical application of respiratory elastance (CARE trial) for mechanically ventilated respiratory failure patients: a model-based study
title_fullStr Clinical application of respiratory elastance (CARE trial) for mechanically ventilated respiratory failure patients: a model-based study
title_full_unstemmed Clinical application of respiratory elastance (CARE trial) for mechanically ventilated respiratory failure patients: a model-based study
title_sort clinical application of respiratory elastance (care trial) for mechanically ventilated respiratory failure patients: a model-based study
publisher IFAC Secretariat
publishDate 2018
url http://irep.iium.edu.my/70221/
http://irep.iium.edu.my/70221/
http://irep.iium.edu.my/70221/
http://irep.iium.edu.my/70221/1/70221_Clinical%20Application%20of%20Respiratory%20Elastance%20%28CARE%20Trial%29_article.pdf
http://irep.iium.edu.my/70221/2/70221_Clinical%20Application%20of%20Respiratory%20Elastance%20%28CARE%20Trial%29_scopus.pdf
first_indexed 2023-09-18T21:39:41Z
last_indexed 2023-09-18T21:39:41Z
_version_ 1777413056076185600

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