Monitoring and regulation of supported breathing in Intensive Care

Abstract

This thesis describes several chapters related to monitoring and regulation of breathing. The main goal is to provide better insight in the interaction between spontaneous breathing and mechanical ventilatory support. In chapter 2 we investigated the effect of metabolic alkalosis on the ventilatory response. To analyze whether speckle tracking ultrasound can be used to noninvasively quantify diaphragm contractility, in chapter 3 this technique is used in healthy subjects undergoing a randomized stepwise threshold loading protocol. Chapters 4, 5 and 6 of this thesis focus on the interaction between the two parallel systems involved in providing adequate ventilation: the patient and more specific its upper airway, and the ventilator. We studied this interaction in patients with an acute exacerbation of COPD during noninvasive ventilation