Alveolar recruitment can be predicted from airway pressure-lung volume loops: an experimental study in a porcine acute lung injury model.

Critical Care : the Official Journal of the Critical Care Forum
Jacob Koefoed-NielsenA Larsson

Abstract

Simple methods to predict the effect of lung recruitment maneuvers (LRMs) in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are lacking. It has previously been found that a static pressure-volume (PV) loop could indicate the increase in lung volume induced by positive end-expiratory pressure (PEEP) in ARDS. The purpose of this study was to test the hypothesis that in ALI (1) the difference in lung volume (DeltaV) at a specific airway pressure (10 cmH2O was chosen in this test) obtained from the limbs of a PV loop agree with the increase in end-expiratory lung volume (DeltaEELV) by an LRM at a specific PEEP (10 cmH2O), and (2) the maximal relative vertical (volume) difference between the limbs (maximal hysteresis/total lung capacity (MH/TLC)) could predict the changes in respiratory compliance (Crs), EELV and partial pressures of arterial O2 and CO2 (PaO2 and PaCO2, respectively) by an LRM. In eight ventilated pigs PV loops were obtained (1) before lung injury, (2) after lung injury induced by lung lavage, and (3) after additional injurious ventilation. DeltaV and MH/TLC were determined from the PV loops. At all stages Crs, EELV, PaCO2 and PaO2 were registered at 0 cmH2O and at 10 cmH2O before and after L...Continue Reading

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Citations

Mar 10, 2012·American Journal of Respiratory Cell and Molecular Biology·Stefanie PreussMartin F Krause
Apr 9, 2008·Critical Care : the Official Journal of the Critical Care Forum·Ralf Kuhlen
Apr 18, 2008·Critical Care : the Official Journal of the Critical Care Forum·Jean-Michel ConstantinJean-Etienne Bazin
Oct 30, 2009·Critical Care : the Official Journal of the Critical Care Forum·Haibo Zhang, Arthur S Slutsky
Dec 10, 2009·Current Opinion in Critical Care·Luciano GattinoniPietro Caironi
Jul 28, 2010·Expert Review of Respiratory Medicine·Patricia R M RoccoMarcelo Gama de Abreu
Jul 12, 2011·Critical Care Clinics·Carl F Haas
Aug 3, 2020·Pediatric Pulmonology·Yasser N ElsayedShyamala Dakshinamurti
Sep 9, 2020·Critical Care Medicine·Davide ChiumelloSilvia Coppola
Oct 24, 2020·Critical Care : the Official Journal of the Critical Care Forum·Gaetano ScaramuzzoTommaso Mauri

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