[The role of the static P-V curve under zero end-expiratory pressure in sustained inflation in patients with acute respiratory distress syndrome].
OBJECTIVE
To evaluate the value of static P-V curve under zero end-expiratory pressure (ZEEP) in predicting the effect of sustained inflation (SI) on hemodynamics, oxygenation and alveolar recruitment in patients with acute respiratory distress syndrome (ARDS).


METHODS
Static P-V curve was measured under positive end-expiratory pressure (PEEP) in all the patients 2 h afer PEEP was applied. Patients who experienced more than 20% increase in PaO(2)/FiO(2) were considered as responders to SI.


RESULTS
(1) The static P-V curves in responders consistently showed a concave pattern with c-2d >or= 0 cm H(2)O (1 cm H(2)O = 0.098 kpa) and c >or= 18 cm H(2)O, while those in non-responders showed a convex pattern with c-2d < 0 cm H(2)O or c < 18 cm H(2)O. (2) After SI, decrease of Q(s)/Q(t) (P = 0.006) was found in responders, but not in non-responders (P = 0.339). The amount of recruited volume was significantly higher in responders than in non-responders after SI [(241 +/- 111) ml vs (29 +/- 46) ml, P = 0.036].


CONCLUSIONS
The static P-V curves under ZEEP exhibited different patterns in responders and non-responders to SI in ARDS patients, and may be of value in predicting the response to SI.
Long
Yun
Y
Intensive Care Unit, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Liu
Da-wei
DW
Du
Bin
B
Ma
Sui
S
Wang
Hao
H
Mo
Xiao-li
XL
Chai
Wen-zhao
WZ
Shi
Yan
Y
Rui
Xi
X
Cui
Na
N
D000328:Adult; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods; D011237:Predictive Value of Tests; D011650:Pulmonary Alveoli / Q000503:physiopathology; D012128:Respiratory Distress Syndrome / Q000503:physiopathology* / Q000628:therapy*