Abstract
In volume control mode, inspiratory pressure curve shows the resistances and compliance of the respiratory system and suggests tidal recruitment or tidal lung overdistension. Plateau pressure is measured by an end-inspiratory occlusion to assess end-inspiratory alveolar pressure. There are several pitfalls in interpreting end-inspiratory occlusion curve. Driving pressure is another important variable to monitor. In pressure control mode, inspiratory flow curve depends on the time constant of the respiratory system. It is used to optimize inspiratory time. Plateau pressure and driving pressure are also important to monitor.
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Amato MB, Meade MO, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med. 2015;372:747–55.
Baedorf Kassis E, Loring SH, et al. Mortality and pulmonary mechanics in relation to respiratory system and transpulmonary driving pressures in ARDS. Intensive Care Med. 2016;42:1206–13.
Barberis L, Manno E, et al. Effect of end-inspiratory pause duration on plateau pressure in mechanically ventilated patients. Intensive Care Med. 2003;29:130–4.
Bigatello LM, Davignon KR, et al. Respiratory mechanics and ventilator waveforms in the patient with acute lung injury. Respir Care. 2005;50:235–45.
Chiumello D, Carlesso E, et al. Airway driving pressure and lung stress in ARDS patients. Crit Care. 2016;20:276.
Dhand R. Ventilator graphics and respiratory mechanics in the patient with obstructive lung disease. Respir Care. 2005;50:246–61.
Fernández-Pérez ER, Hubmayr RD. Interpretation of airway pressure waveforms. Intensive Care Med. 2006;32:658–9.
Guérin C, Papazian L, et al. Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials. Crit Care. 2016;20:384.
Iotti G, Braschi A. Measurement of respiratory mechanics during mechanical ventilation. Rhäzüns, Switzerland: Hamilton Medical Scientific Library; 1999.
Laffey JG, Bellani G, et al. Potentially modifiable factors contributing to outcome from acute respiratory distress syndrome: the LUNG SAFE study. Intensive Care Med. 2016;42:1865–76.
Marini JJ, Ravenscraft SA. Mean airway pressure: physiologic determinants and clinical importance--part 1: physiologic determinants and measurements. Crit Care Med. 1992a;20:1461–72.
Marini JJ, Ravenscraft SA. Mean airway pressure: physiologic determinants and clinical importance-- part 2: clinical implications. Crit Care Med. 1992b;20:1604–16.
Neto AS, Hemmes SN, et al. Association between driving pressure and development of postoperative pulmonary complications in patients undergoing mechanical ventilation for general anaesthesia: a meta-analysis of individual patient data. Lancet Respir Med. 2016;4:272–80.
Nilsestuen JO, Hargett KD. Using ventilator graphics to identify patient-ventilator asynchrony. Respir Care. 2005;50:202–34.
Ranieri VM, Zhang H, et al. Pressure-time curve predicts minimally injurious ventilatory strategy in an isolated rat lung model. Anesthesiology. 2000;93:1320–8.
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2.1 Electronic Supplementary Material
Pressure curve in VC (AVI 235029 kb)
Flow pattern in VC (AVI 516134 kb)
End-inspiratory occlusion in VC (AVI 179727 kb)
Driving pressure in VC (AVI 315671 kb)
Flow curve in PC (AVI 435490 kb)
Inspiratory time in PC (AVI 813376 kb)
End-inspiratory occlusion in PC with end-inspiratory flow at zero (AVI 200463 kb)
End-inspiratory occlusion in PC with end-inspiratory flow positive (AVI 205073 kb)
Driving pressure in PC (AVI 313368 kb)
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Arnal, JM. (2018). Controlled Modes. In: Monitoring Mechanical Ventilation Using Ventilator Waveforms. Springer, Cham. https://doi.org/10.1007/978-3-319-58655-7_2
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DOI: https://doi.org/10.1007/978-3-319-58655-7_2
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