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We did not investigate whether the point of maximum compliance increase really reflects the lower inflection point (LIP).
The corner points stating the point of maximum compliance increase and decrease, being the mathematical equivalents of lower and upper inflection points, were calculated.
The resultant increase in the inflational point of maximum compliance increase correlated with the increase in the sum of VNORM and VPOOR (r = 0.914) (Fig. 5d).
If the point of maximum compliance increase truly represented the commencement of alveolar recruitment, it should be lower in conditions with less atelectasis.
We were surprised that the inflation point of maximum compliance increase actually increased after recruitment in a nonlinear way (Fig. 5d), with a sharp increase beyond an increase in aerated lung >20%.
Instead, a significant correlation was observed between poorly aerated lung volume and the PaO2 (r = 0.569, p = 0.022) (Fig. 1c) and also between VPOOR and respiratory system compliance (r = 0.719, p = 0.006) (Fig. 1a) and the inflation pressure maximum compliance increase (r = 0.655, p = 0.008).
Similar(54)
They found that dynamic tidal respiratory compliance, maximum PaO2, maximum PaO2 + PaCO2, minimal shunt, lower inflection point (P FLEX), and the point of maximal compliance increase (Pmci,i) on the inflation limb of the pressure-volume (P-V) curve all set a similar level of PEEP.
Maximal compliance increase.
In a range of 8 mbar (4 PEEP steps), the maximum relative change of compliance was only 2% (1%; in relation to maximum compliance).
After a few minutes, the compliance increase significantly.
Lung compliance increase to satifactory values (21.4 ± 3.1; 21.48 ± 2.4).
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