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Exact(5)
The minimum respiratory system elastance corresponded to the greatest amount of normally aerated lung with minimal tidal recruitment and hyperinflation.
A notable strength of this study was the physiological method used to set PEEP in the CMV open lung group; this PEEP value corresponded to the minimum respiratory system elastance.
Unfortunately the practical application of this measure appears to be limited because most cases did not exhibit a defined minimum value, with the minimum respiratory system elastance occurring within a range of PEEP values between 4 and 8 cmH2O.
Moreover, the investigators set the HFOV mean airway 2 cmH2O above the mean airway pressure measured during CMV and 'best PEEP' corresponding to the minimum respiratory system elastance: in this way the CMV and HFOV open lung approaches were very comparable.
In healthy piglets in the supine position, in a protocol of descendent PEEP, with a previous full lung re-aeration, the minimum respiratory system elastance corresponded to the greatest amount of normally aerated areas with approximately minimal tidal re-aeration and hyperinflation, according to morphologic analysis by CT scan.
Similar(54)
We hypothesized that in the presence of massive brain injury, a ventilation strategy using low VT and PEEP set according to the minimum elastance of the respiratory system (LVT/OLPEEP) may improve lung morphofunction and minimize VALI more effectively than a ventilation regimen using high VT and low PEEP (HVT/LPEEP).
γ: minimum surface tension; Crs: static compliance of the respiratory system; FFA: free fatty acids; OI: oxygenation index.
Respiratory system static inflation end-inspiratory compliance (Crs), minimum (Rint) and maximum (Rrs) resistance of the respiratory system and the difference between Rrs and Rint (Δ R) were computed according to standard formulas and procedures [ 11, 12].
End-inspiratory static compliance of the respiratory system (Crs, st) as well as minimum (Rint) and maximum (Rrs) resistance of the respiratory system were computed according to standard formulas [ 25, 26].
Crs, end-inspiratory static compliance of the respiratory system (ml/cmH2O); Fr, ventilator frequency (breaths/min); Rint and Rrs, minimum and maximum inspiratory resistance (cmH2O/l per second), respectively; VT, tidal volume (litres).
ALI = acute lung injury; CT = computed tomography; Ers = elastance of the respiratory system; PEEP = positive end-expiratory pressure; PEEPErs = PEEP at which the minimum Ers was observed; Rrs = resistance of the respiratory system; VT = tidal volume; ZEEP = zero end-expiratory pressure.
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