• R Peslin.
• Physiopathologie Respiratoire, Vandoeuvre-les-Nancy, France.
• Br J Anaesth. 1989 Jan 1;63(7 Suppl 1):91S-94S.

AbstractThe usefulness of measuring respiratory flow in the airway and at the chest wall and of measuring respiratory input impedance (Z) to monitor high frequency ventilation was investigated by computer simulation using a monoalveolar 10-coefficient model. The latter included a central airway with its resistance (Rc) and inertance (lc), a resistive peripheral airway (Rp), a lumped bronchial compliance (Cb), alveolar gas compliance (Cgas), lung tissue with its resistance (RL) and compliance (CL), and chest wall resistance (RW), inertance (lw) and compliance (Cw). Gas flow in the peripheral airway (Vp), shunt flow through Cb (Vb), gas compression flow (Vgas) and rate of volume change of the lung (VL) and of the chest (VW) were computed and expressed as a function of gas flow in the central airway (Vc). For normal values of the coefficients, Vp/Vc was found to decrease moderately with increasing frequency and was still 0.75 at 20 Hz. Peripheral airway obstruction (Rp x 5) considerably decreased Vp/Vc, particularly at high frequency. It did not change the relationship between the two measurable flows, Vc and Vw, but increased the effective resistance at low frequency and shifted the reactance curve to the right. A reduced lung or chest wall compliance produced little change in Vp/Vc and Z except at very low frequencies; however, it decreased the phase lag between Vw and Vc. Finally, an increased airway wall compliance decreased Vp/Vc, but had little effect on Z and Vw/Vc. It is concluded that measuring respiratory impedance may help in detecting some, but not all of the conditions in which peripheral flow convection is decreased during high frequency oscillations.

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