title: Peak volume history and peak pressure-volume curve pressures independently affect the shape of the pressure-volume curve of the respiratory system.
abstract: OBJECTIVE
  To determine the specific effect of peak volume history pressure on the inflation limb of the pressure-volume curve and peak pressure-volume curve pressure on the deflation limb of the pressure-volume curve.
  
  
  METHODS
  Prospective assessment of pressure-volume curves in saline, lung lavage injured sheep.
  
  
  METHODS
  Large animal laboratory of a university-affiliated hospital.
  
  
  METHODS
  Eight female Dorset sheep.
  
  
  METHODS
  : The effect of two volume history pressures (40 and 60 cm H2O) and three pressure-volume curve peak pressures (40, 50, and 60 cm H2O) were randomly compared.
  
  
  RESULTS
  Peak volume history pressure affected the inflation curve beyond the lower inflection point but did not affect the inflection point (Pflex). Peak pressure-volume curve pressure affected the deflation curve. Increased peak volume history pressure increased inflation compliance (p <.05). Increased peak pressure-volume curve pressure increased the point of maximum compliance change on the deflation limb and deflation compliance and decreased compliance between peak pressure and the point of maximum curvature on the deflation limb (p <.05).
  
  
  CONCLUSIONS
  Peak volume history pressure must be considered when interpreting the inflation limb of the pressure-volume curve of the respiratory system beyond the inflection point. The peak pressure achieved during the pressure-volume curve is important during interpretation of deflation compliance and the point of maximum compliance change on the deflation limb.
authors.affiliation: Department of Anesthesia/Respiratory Care, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Tomoyo
authors.initials: T
authors.lastname: Nishida
authors.forename: Klaudiusz
authors.initials: K
authors.lastname: Suchodolski
authors.forename: Guilherme P P
authors.initials: GP
authors.lastname: Schettino
authors.forename: Khaled
authors.initials: K
authors.lastname: Sedeek
authors.forename: Muneyuki
authors.initials: M
authors.lastname: Takeuch
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kacmarek
mesh_terms: D000818:Animals; D001992:Bronchoalveolar Lavage Fluid; D005260:Female; D008170:Lung Compliance / Q000502:physiology; D011446:Prospective Studies; D011897:Random Allocation; D012128:Respiratory Distress Syndrome / Q000503:physiopathology*; D012756:Sheep