Degree of convexity calculated from expiratory flow-volume curves for identifying airway obstruction in nonsedated and nonparalyzed ventilated patients

Respir Physiol Neurobiol. 2021 Nov:293:103739. doi: 10.1016/j.resp.2021.103739. Epub 2021 Jul 7.

Abstract

The predictive performance of applying the degree of convexity in expiratory flow-volume (EFV) curves to detect airway obstruction in ventilated patients has yet to be investigated. We enrolled 33 nonsedated and nonparalyzed mechanically ventilated patients and found that the degree of convexity had a significant negative correlation with FEV1% predicted. The mean degree of convexity in EFV curves in the chronic obstructive pulmonary disease (COPD) group (n = 18) was significantly higher than that in the non-COPD group (n = 15; 26.37 % ± 11.94 % vs. 17.24 % ± 10.98 %, p = 0.030) at a tidal volume of 12 mL/kg IBW. A degree of convexity in the EFV curve > 16.75 at a tidal volume of 12 mL/kg IBW effectively differentiated COPD from non-COPD (AUC = 0.700, sensitivity = 77.8 %, specificity = 53.3 %, p = 0.051). The degree of convexity calculated from EFV curves may help physicians to identify ventilated patients with airway obstruction.

Keywords: Degree of convexity; Expiratory flow-volume curves; Mechanical ventilation.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Airway Obstruction / diagnosis*
  • Airway Obstruction / physiopathology*
  • Airway Obstruction / therapy
  • Exhalation / physiology*
  • Female
  • Humans
  • Male
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Pulmonary Ventilation / physiology*
  • Respiration, Artificial*
  • Retrospective Studies
  • Tidal Volume / physiology