Intensive Care Medicine

, 34:2019

Recruitability of the lung estimated by the pressure volume curve hysteresis in ARDS patients

  • Didier Demory
  • Jean-Michel Arnal
  • Marc Wysocki
  • Stéphane Donati
  • Isabelle Granier
  • Gaëlle Corno
  • Jacques Durand-Gasselin
Original

DOI: 10.1007/s00134-008-1167-8

Cite this article as:
Demory, D., Arnal, JM., Wysocki, M. et al. Intensive Care Med (2008) 34: 2019. doi:10.1007/s00134-008-1167-8

Abstract

Objective

To assess the hysteresis of the pressure–volume curve (PV curve) as to estimate, easily and at the bedside, the recruitability of the lung in ARDS patients.

Design

Prospective study.

Setting

Twelve medico-surgical ICU beds of a general hospital.

Patients

Twenty-six patients within the first 24 h from meeting ARDS criteria.

Intervention

A Quasi-static inflation and deflation PV curve from 0 to 40 cmH2O and a 40 cmH2O recruitment maneuver (RM) maintained for 10 s were successively done with an interval of 30 min in between.

Recordings and calculation

Hysteresis of the PV curve (HPV) was calculated as the ratio of the area enclosed by the pressure volume loop divided by the predicted body weight (PBW). The volume increase during the RM (VRM) was measured by integration of the flow required to maintain the pressure at 40 cmH2O and divided by PBW, as an estimation of the volume recruited during the RM.

Results

A positive linear correlation was found between HPV and VRM (r = 0.81, P < 0.0001).

Conclusions

The results suggest using the hysteresis of the PV curve to assess the recruitability of the lung.

Keywords

ALI/ARDS Mechanical ventilation Pressure–volume curves Hysteresis Recruitment maneuver Positive end-expiratory pressure 

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Didier Demory
    • 1
  • Jean-Michel Arnal
    • 1
  • Marc Wysocki
    • 2
  • Stéphane Donati
    • 1
  • Isabelle Granier
    • 1
  • Gaëlle Corno
    • 1
  • Jacques Durand-Gasselin
    • 1
  1. 1.Service de réanimation polyvalente, Hôpital Font PréToulonFrance
  2. 2.Department of Medical ResearchHamilton MedicalBonaduzSwitzerland