Use of dynamic compliance for open lung positive end-expiratory pressure titration in an experimental study

• DOI: 10.1097/01.ccm.0000251131.40301.e2
• Publication Date: 2006-11-22T17:17:49Z
• Authors: Fernando Suarez-S...; Stephan H. Böhm; Gerardo Tusman; Tanja Pesch; Oliver Thamm; Hajo Reissmann; Andreas Reske; Anders Magnusson; Göran Hedenstierna
• Keywords: Pulmonary compliance; Positive End-Expiratory Pressure; Respiratory physiology

We tested whether the continuous monitoring of dynamic compliance could become a useful bedside tool for detecting beginning collapse fully recruited lung.Prospective laboratory animal investigation.Clinical physiology research laboratory, University Uppsala, Sweden.Eight pigs submitted to repeated lung lavages.Lung recruitment maneuver, effect which was confirmed by predefined oxygenation, mechanics, and computed tomography scan criteria, followed positive end-expiratory pressure (PEEP) reduction trial in volume control mode with tidal 6 mL/kg. Every 10 mins, PEEP reduced steps 2 cm H2O starting from 24 H2O. During reduction, defined maximum value after first measurable decrease occurred. Open according then as level before point collapse. This compared oxygenation (Pao2) CT scans.Pao2 were monitored continuously, whereas scans obtained at end each step. Collapse occurred 14 coincided oxygenation-based when also shunt started increase one step percentage nonaerated tissue on exceeded 5%. thus 16 H2O, open, not yet collapsed condition.In this experimental model, identified recruitment. These findings scans. method might valuable identifying that prevents