Measurement of pressure-volume curves in patients on mechanical ventilation: methods and significance.
Physiological background concerning mechanics of the respiratory system, techniques of measurement and clinical implications of pressure-volume curve measurement in mechanically ventilated patients are discussed in the present review. The significance of lower and upper inflection points, the assessment of positive end-expiratory pressure (PEEP)-induced alveolar recruitment and overdistension and rationale for optimizing ventilatory settings in patients with acute lung injury are presented. Evidence suggests that the continuous flow method is a simple and reliable technique for measuring pressure-volume curves at the bedside. In patients with acute respiratory failure, determination of lower and upper inflection points and measurement of respiratory compliance should become a part of the routine assessment of lung injury severity, allowing a bedside monitoring of the evolution of the lung disease and an optimization of mechanical ventilation.
Lu
Q
Q
University of Paris VI, Paris, France. qin.lu@psl.ap-hop-paris.fr
Rouby
J J
JJ
D003422:Critical Care / Q000379:methods; D016638:Critical Illness; D005260:Female; D006801:Humans; D055370:Lung Injury; D008176:Lung Volume Measurements; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D018467:Positive-Pressure Respiration, Intrinsic; D011379:Prognosis; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000628:therapy*; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index