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This is supported by two physiologic studies using a porcine-ARDS model that showed VD/Vt was useful for identifying lung collapse and the optimal PEEP necessary to maintain lung volume following a RM [79, 80].
In both treatment arms a priority was given to maintain lung volume while minimizing peak pressures.
One of the notable limitations of the present study is that animals were received a muscle relaxant, which may have inhibited the animal's efforts to maintain lung volume and altered regional differences in lung volume and ventilation.
The hysteresis of the lungs provides an additional benefit: when oscillating on the expiratory limb, less pressure is required to maintain lung volume in comparison with when oscillating on the inspiratory limb.
Less injurious low tidal volume can lead to impaired oxygenation [ 4], and even very high PEEP can be insufficient to maintain lung volume in patients with severe ARDS [ 3].
The priority in both treatment arms was to maintain lung volume by first weaning FiO2 to < 0.60 after which mean airway pressure and FiO2 were given equal priority for reduction.
Similar(53)
The study demonstrated that the combination of pre-oxygenation with NIV + post¬intubation RM helped maintain lung volumes and oxygenation during anesthesia induction more so than pre-oxygenation with either pure oxygen alone or with NIV.
Introduction: We have previously found that during spontaneous breathing (SB) the diaphragm exerts an expiratory breaking effect, maintaining lung volume.
Therefore, infants compensate for this mechanical disadvantage by actively maintaining lung volume above the resting volume which affects significantly the measured TB parameters.
A strategy to reduce this effect is the 'open-lung' strategy of maintaining lung volumes with positive end-expiratory pressure (PEEP) or HFOV.
This would help to maintain the increased level of IAP found in our results and necessary for the next expiratory cough as well as to conserve lung volume until the threat to the airway has been resolved.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com