Static versus dynamic respiratory mechanics for setting the ventilator

Br J Anaesth. 2000 Oct;85(4):577-86. doi: 10.1093/bja/85.4.577.

Abstract

The lower inflection point (LIP) of the inspiratory limb of a static pressure-volume (PV) loop is assumed to indicate the pressure at which most lung units are recruited. The LIP is determined by a static manoeuvre with a PV-history that is different from the PV-history of the actual ventilation. In nine surfactant-deficient piglets, information to allow setting PEEP and VT was obtained, both from the PV-curve and also during ongoing ventilation from the dynamic compliance relationship. According to LIP, PEEP was set at 20 (95% confidence interval 17-22) cm H2O. Volume-dependent dynamic compliance suggested a PEEP reduction (to 15 (13-18) cm H2O). Pulmonary gas exchange remained satisfactory and this change resulted in reduced mechanical stress on the respiratory system, indirectly indicated by volume-dependent compliance being consistently great during the entire inspiration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bronchoalveolar Lavage
  • Female
  • Lung Compliance / physiology
  • Male
  • Positive-Pressure Respiration / methods*
  • Pulmonary Gas Exchange / physiology
  • Pulmonary Surfactants / deficiency
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / therapy*
  • Respiratory Mechanics / physiology*
  • Stress, Mechanical
  • Swine

Substances

  • Pulmonary Surfactants