Effect of Tidal Volume and Positive End-Expiratory Pressure on Compliance during Mechanical Ventilation
| Autor: | Peter M. Suter, H. Barrie Fairley, Michael D. Isenberg |
|---|---|
| Rok vydání: | 1978 |
| Předmět: |
Adult
Lung Diseases Pulmonary and Respiratory Medicine Functional Residual Capacity medicine.medical_treatment Pulmonary compliance Critical Care and Intensive Care Medicine Positive-Pressure Respiration Functional residual capacity Respiration Pressure Tidal Volume Humans Medicine Lung Compliance Tidal volume Positive end-expiratory pressure Aged Mechanical ventilation business.industry Middle Aged Respiration Artificial Compliance (physiology) Anesthesia Breathing Pulmonary Ventilation Respiratory Insufficiency Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest. 73:158-162 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.73.2.158 |
| Popis: | In 12 patients requiring therapy with mechanical ventilation for acute respiratory failure, total static compliance (Cst) increased from 29 ± 4 ml/cm H 2 O at a tidal volume (TV) of 5 ml/kg to 42 ± 7 ml/cm H 2 O at a TV of 15 ml/kg. Similarly, Cst increased from 42 ± 7 ml/cm H 2 O to 52 ± 8 ml/cm H 2 O between 0 and 6 cm H 2 O of positive end-expiratory pressure (PEEP). At high levels of pulmonary inflation ( ie, high PEEP and large TV) compliance decreased. The changes of total respiratory compliance with TV were mainly due to changes in pulmonary compliance. With PEEP, the functional residual capacity increased, and specific compliance did not change. Two mechanisms may be responsible for the changes in compliance. First, varying TV or PEEP will alter the position of tidal ventilation on the pressure-volume curve, resulting in an increase in compliance with increasing TV and PEEP up to a point, where overdistention occurs and compliance decreases. Secondly, the function of the surface-lowering substance may be altered in acute pulmonary parenchymal disease, thus disturbing the regulation of surface tension over the range of pulmonary Inflation studied. |
| Databáze: | OpenAIRE |
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