References of "Chase, JG"
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See detailEffects of Neurally Adjusted Ventilatory Assist (NAVA) levels in non-invasive ventilated patients: titrating NAVA levels with electric diaphragmatic activity and tidal volume matching
Chiew, YS; Chase, JG; LAMBERMONT, Bernard ULg et al

in BioMedical Engineering OnLine (2013)

BACKGROUND: Neurally adjusted ventilatory assist (NAVA) delivers pressure in proportion to diaphragm electrical activity (Eadi). However, each patient responds differently to NAVA levels. This study aims ... [more ▼]

BACKGROUND: Neurally adjusted ventilatory assist (NAVA) delivers pressure in proportion to diaphragm electrical activity (Eadi). However, each patient responds differently to NAVA levels. This study aims to examine the matching between tidal volume (Vt) and patients' inspiratory demand (Eadi), and to investigate patient-specific response to various NAVA levels in non-invasively ventilated patients. METHODS: 12 patients were ventilated non-invasively with NAVA using three different NAVA levels. NAVA100 was set according to the manufacturer's recommendation to have similar peak airway pressure as during pressure support. NAVA level was then adjusted ±50% (NAVA50, NAVA150). Airway pressure, flow and Eadi were recorded for 15 minutes at each NAVA level. The matching of Vt and integral of Eadi (ʃEadi) were assessed at the different NAVA levels. A metric, Range90, was defined as the 5-95% range of Vt/ʃEadi ratio to assess matching for each NAVA level. Smaller Range90 values indicated better matching of supply to demand. RESULTS: Patients ventilated at NAVA50 had the lowest Range90 with median 25.6 uVs/ml [Interquartile range (IQR): 15.4-70.4], suggesting that, globally, NAVA50 provided better matching between ʃEadi and Vt than NAVA100 and NAVA150. However, on a per-patient basis, 4 patients had the lowest Range90 values in NAVA100, 1 patient at NAVA150 and 7 patients at NAVA50. Robust coefficient of variation for ʃEadi and Vt were not different between NAVA levels. CONCLUSIONS: The patient-specific matching between ʃEadi and Vt was variable, indicating that to obtain the best possible matching, NAVA level setting should be patient specific. The Range90 concept presented to evaluate Vt/ʃEadi is a physiologic metric that could help in individual titration of NAVA level. [less ▲]

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See detailExpiratory model-based method to monitor ARDS disease state
Van Drunen, EJ; Chiew, YS; Chase, JG et al

in BioMedical Engineering OnLine (2013)

INTRODUCTION: Model-based methods can be used to characterise patient-specific condition and response to mechanical ventilation (MV) during treatment for acute respiratory distress syndrome (ARDS ... [more ▼]

INTRODUCTION: Model-based methods can be used to characterise patient-specific condition and response to mechanical ventilation (MV) during treatment for acute respiratory distress syndrome (ARDS). Conventional metrics of respiratory mechanics are based on inspiration only, neglecting data from the expiration cycle. However, it is hypothesised that expiratory data can be used to determine an alternative metric, offering another means to track patient condition and guide positive end expiratory pressure (PEEP) selection. METHODS: Three fully sedated, oleic acid induced ARDS piglets underwent three experimental phases. Phase 1 was a healthy state recruitment manoeuvre. Phase 2 was a progression from a healthy state to an oleic acid induced ARDS state. Phase 3 was an ARDS state recruitment manoeuvre. The expiratory time-constant model parameter was determined for every breathing cycle for each subject. Trends were compared to estimates of lung elastance determined by means of an end-inspiratory pause method and an integral-based method. All experimental procedures, protocols and the use of data in this study were reviewed and approved by the Ethics Committee of the University of Liege Medical Faculty. RESULTS: The overall median absolute percentage fitting error for the expiratory time-constant model across all three phases was less than 10 %; for each subject, indicating the capability of the model to capture the mechanics of breathing during expiration. Provided the respiratory resistance was constant, the model was able to adequately identify trends and fundamental changes in respiratory mechanics. CONCLUSION: Overall, this is a proof of concept study that shows the potential of continuous monitoring of respiratory mechanics in clinical practice. Respiratory system mechanics vary with disease state development and in response to MV settings. Therefore, titrating PEEP to minimal elastance theoretically results in optimal PEEP selection. Trends matched clinical expectation demonstrating robustness and potential for guiding MV therapy. However, further research is required to confirm the use of such real-time methods in actual ARDS patients, both sedated and spontaneously breathing. [less ▲]

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See detailAssessment of ventricular contractility and ventricular-arterial coupling with a model-based sensor.
Desaive, Thomas ULg; LAMBERMONT, Bernard ULg; JANSSEN, Nathalie ULg et al

in Computer Methods & Programs in Biomedicine (2013), 109(2),

Estimation of ventricular contractility and ventricular arterial coupling is clinically important in diagnosing and treating cardiac dysfunction in the critically ill. However, experimental assessment of ... [more ▼]

Estimation of ventricular contractility and ventricular arterial coupling is clinically important in diagnosing and treating cardiac dysfunction in the critically ill. However, experimental assessment of indexes of ventricular contractility, such as the end-systolic pressure-volume relationship, requires a highly invasive maneuver and measurements that are not typical in an intensive care unit (ICU). This research describes the use of a previously validated cardiovascular system model and parameter identification process to evaluate the right ventricular arterial coupling in septic shock. Model-based ventricular arterial coupling is defined by the ratio of the end systolic right ventricular elastance (E(esrvf)) over the pulmonary artery elastance (E(pa)) or the mean pulmonary inflow resistance (R(pulin)). Results are compared to the clinical gold-standard assessment (conductance catheter method). Six anesthetized healthy pigs weighing 20-30kg received a 0.5mgkg(-1) endotoxin infusion over a period of 30min from T0 to T30, to induce septic shock and veno-venous hemofiltration was used from T60 onward. The results show good agreement with the gold-standard experimental assessment. In particular, the model-based right ventricular elastance (E(esrvf)) correlates well with the clinical gold standard (R(2)=0.69) and the model-based non-invasive coupling (E(esrvf)/R(pulin)) follow the same trends and dynamics (R(2)=0.37). The overall results show the potential to develop a model-based sensor to monitor ventricular-arterial coupling in clinical real-time. [less ▲]

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See detailAnalysis of different model-based approaches for estimating dFRC for real-time application
van Drunen, EJ; Chase, JG; Chiew, YS et al

in BioMedical Engineering OnLine (2013), 12:9

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See detailComputer-based monitoring of global cardiovascular dynamics during acute pulmonary embolism and septic shock in swine
Revie, JA; Stevenson, D; Chase, JG et al

in Critical Care (2012), 16 (Suppl 1)

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See detailVariability of insulin sensitivity during the first 4 days of critical illness
Pretty, Christopher ULg; Le Compte, A; Chase, JG et al

in Critical Care (2012), 16 (Suppl 1)

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See detailCumulative time in band (cTIB): glycemic level, variability and patient outcome vs mortality
Penning, Sophie ULg; Signal, M; Preiser, JC et al

in Proceedings of ANZICS 2012 (2012)

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See detailRespiratory system elastance monitoring during PEEP titration
Chiew, YS; Chase, JG; Shaw, GM et al

in Critical Care (2012), 34 (Suppl 1)

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See detailPilot Trial of STAR in Medical ICU
Fisk, LM; Le Compte, A; Shaw, GM et al

in Critical Care (2012), 16 (Suppl 1)

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See detailEvolution de l’insulino-résistance au cours de l’hypothermie thérapeutique
Moermans, A; Taccone, F; Penning, Sophie ULg et al

in Proceedings des journees francophone de nutrition 2012 (2012)

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See detailPhysiological Relevance of a Minimal Model in Healthy Pigs Lungs
Chiew, YS; Desaive, Thomas ULg; LAMBERMONT, Bernard ULg et al

in Proceedings of BMS 2012 (2012)

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See detailPerformance of lung recruitment model in healthy anesthetised pigs
Chiew, YS; LAMBERMONT, Bernard ULg; JANSSEN, Nathalie ULg et al

in Proceedings of the World Congress on Medical Physics and Biomedical Engineering 2012 (2012)

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See detailRange90 as indicator for ventilator output versus patients demand: NAVA and pressure support for non-invasively ventilated patients
Chiew, YS; Piquilloud, L.; LAMBERMONT, Bernard ULg et al

in Proceedings of the World Congress on Medical Physics and Biomedical Engineering 2012 (2012)

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See detailGlucose control: How tight? - How modeling could help?
Desaive, Thomas ULg; Chase, JG

Conference (2012)

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See detailEstimating afterload, systemic vascular resistance and pulmonary vascular resistance in an intensive care setting
Stevenson, D; Revie, J.; Chase, JG et al

in Proceedings of BMS2012 (2012)

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See detailCardiovascular modelling and the Intensive Care Unit clinician
Desaive, Thomas ULg; LAMBERMONT, Bernard ULg; Kolh, Philippe ULg et al

in Proceedings of BMS 2012 (2012)

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See detailModel-based Monitoring of Septic Shock Treated with Large-Pore Hemofiltration Therapy
Revie; Stevenson, D; Chase, JG et al

in Proceedings of BMS 2012 (2012)

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See detailAnalysis of Aortic Energetics from Pulse Wave Examination in a Porcine Study of Septic Shock
Revie, JA; Stevenson, D; Chase, JG et al

in Prceedings of BMS 2012 (2012)

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See detailRespiratory variability in mechanically ventilated patients
Desaive, Thomas ULg; Piquilloud, L.; Moorhead, KT et al

in Critical Care (2011), 15 (Suppl 1)

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