Abstract
Patients with obstructive pulmonary diseases, mainly including chronic obstructive pulmonary disease (COPD) and asthma, compromise a considerable proportion of mechanically ventilated patients in the intensive care unit (ICU) [1]. Mechanically ventilated patients with comorbidity of COPD might have a longer duration of ventilation with difficult weaning. Nowadays, modern ventilators can display pressure-, flow-, and volume-time tracings, as well as pressure-volume and flow-volume curves at the bedside. Additionally, advanced respiratory mechanics monitoring modalities, such as esophageal pressure and electrical activity of the diaphragm, are available to provide sophisticated analysis of breathing efforts and diaphragm function. This information facilitates early identification of abnormalities, detection of patient-ventilator asynchrony, and optimization of mechanical ventilation settings. In this chapter, based on the introduction of the main pathophysiologic alterations in patients with obstructive pulmonary diseases undergoing mechanical ventilation, we will discuss respiratory mechanics monitoring, specifically on the measurement of dynamic hyperinflation and air trapping. In the end, we will briefly introduce the principle for ventilation management in this population.
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Zhou, JX., Li, HL. (2021). Obstructive Pulmonary Disease. In: Zhou, JX., Chen, GQ., Li, HL., Zhang, L. (eds) Respiratory Monitoring in Mechanical Ventilation. Springer, Singapore. https://doi.org/10.1007/978-981-15-9770-1_7
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