help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by LICHTWARCK-ASCHOFF, M.
Right arrow Articles by SJÖSTRAND, U. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by LICHTWARCK-ASCHOFF, M.
Right arrow Articles by SJÖSTRAND, U. H.

Am. J. Respir. Crit. Care Med., Volume 162, Number 6, December 2000, 2125-2133

Compliance Is Nonlinear over Tidal Volume Irrespective of Positive End-Expiratory Pressure Level in Surfactant-Depleted Piglets

MICHAEL LICHTWARCK-ASCHOFF, GEORG MOLS, ANDERS J. HEDLUND, VOLKER KESSLER, AGNETA M. MARKSTRÖM, JOSEF GUTTMANN, GÖRAN HEDENSTIERNA, and ULF H. SJÖSTRAND

Departments of Surgical Sciences and Medical Sciences, University Hospital, Uppsala, Sweden; and Department of Anesthesiology and Critical Care Medicine, University of Freiburg, Freiburg, Germany

Between the lower and the upper inflection point of a quasistatic pressure-volume (PV) curve, a segment usually appears in which the PV relationship is steep and linear (i.e., compliance is high, with maximal volume change per pressure change, and is constant). Traditionally it is assumed that when positive end-expiratory pressure (PEEP) and tidal volume (V T) are titrated such that the end-inspiratory volume is positioned at this linear segment of the PV curve, compliance is constant over VT during ongoing ventilation. The validity of this assumption was addressed in this study. In 14 surfactant-deficient piglets, PEEP was increased from 3 cm H2O to 24 cm H2O, and the compliance associated with 10 consecutive volume increments up to full VT was determined with a modified multiple-occlusion method at the different PEEP levels. With PEEP at approximately the lower inflection point, compliance was minimal in most lungs and decreased markedly over VT, indicating overdistension. Compliance both increased and decreased within the same breath at intermediate PEEP levels. It is concluded that a PEEP that results in constant compliance over the full VT range is difficult to find, and cannot be derived from conventional respiratory-mechanical analyses; nor does this PEEP level coincide with maximal gas exchange.




This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
C. Olegard, S. Sondergaard, E. Houltz, S. Lundin, and O. Stenqvist
Estimation of Functional Residual Capacity at the Bedside Using Standard Monitoring Equipment: A Modified Nitrogen Washout/Washin Technique Requiring a Small Change of the Inspired Oxygen Fraction
Anesth. Analg., July 1, 2005; 101(1): 206 - 212.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
C. Rylander, M. Hogman, G. Perchiazzi, A. Magnusson, and G. Hedenstierna
Functional Residual Capacity and Respiratory Mechanics as Indicators of Aeration and Collapse in Experimental Lung Injury
Anesth. Analg., March 1, 2004; 98(3): 782 - 789.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. Sottiaux, A. Villagra, J. L. Aguilar, and L. Blanch
Recruitment maneuvers in ARDS
Am. J. Respir. Crit. Care Med., June 1, 2003; 167(11): 1575 - 1575.
[Full Text]

Home page
 Eur Respir JHome page
E. Kondili, G. Prinianakis, H. Athanasakis, and D. Georgopoulos
Lung emptying in patients with acute respiratory distress syndrome: effects of positive end-expiratory pressure
Eur. Respir. J., May 1, 2002; 19(5): 811 - 819.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
T. J. Nuckton, J. A. Alonso, R. H. Kallet, B. M. Daniel, J.-F. Pittet, M. D. Eisner, and M. A. Matthay
Pulmonary Dead-Space Fraction as a Risk Factor for Death in the Acute Respiratory Distress Syndrome
N. Engl. J. Med., April 25, 2002; 346(17): 1281 - 1286.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. J. ROUBY, Q. LU, and I. GOLDSTEIN
Selecting the Right Level of Positive End-Expiratory Pressure in Patients with Acute Respiratory Distress Syndrome
Am. J. Respir. Crit. Care Med., April 15, 2002; 165(8): 1182 - 1186.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. Jardin
COMPUTED TOMOGRAPHY ASSESSMENT OF POSITIVE END-EXPIRATORY PRESSURE-INDUCED ALVEOLAR RECRUITMENT IN PATIENTS WITH ACUTE RESPIRATORY DISTRESS SYNDROME
Am. J. Respir. Crit. Care Med., February 15, 2002; 165(4): 551 - 551.
[Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN
Critical Care Medicine in AJRCCM 2000
Am. J. Respir. Crit. Care Med., October 15, 2001; 164(8): 1347 - 1361.
[Full Text] [PDF]

Home page
 NEJMHome page
M. J. Tobin
Advances in Mechanical Ventilation
N. Engl. J. Med., June 28, 2001; 344(26): 1986 - 1996.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2000 American Thoracic Society 		  CCM abstracts