Bedside evaluation of pressure-volume curves in patients with acute respiratory distress syndrome.
OBJECTIVE
To describe the physiologic and diagnostic utility of static pressure-volume curves of the respiratory system at the bedside in patients with acute lung injury or acute respiratory distress syndrome.


RESULTS
The pressure-volume curve of the respiratory system is a useful tool for the measurement of respiratory system mechanics in patients with acute lung injury or acute respiratory distress syndrome. The pressure-volume curve has a sigmoid shape, with lower and upper points on the inspiratory limb and a point of maximum curvature on the expiratory limb. Visual and mathematical pressure-volume curve analysis may be useful for understanding individual lung mechanics and for selecting ventilator settings. Among the different techniques for acquiring pressure-volume curves at the bedside, the constant slow flow method is the simplest to perform, the most clinically reliable and has the fewest limitations.


CONCLUSIONS
Measurement of pressure-volume curves at the bedside in critically ill patients with acute lung injury or acute respiratory distress syndrome should be considered a useful respiratory monitoring tool to assess physiologic lung status and to adjust ventilator settings, when appropriate, to minimize superimposed lung injury associated with mechanical ventilators.
Blanch
Lluis
L
Critical Care Center, Hospital de Sabadell, Institut Universitari Fundació Parc Taulí, Universitat Autónoma de Barcelona, Sabadell, Spain. lblanch@cspt.es
López-Aguilar
Josefina
J
Villagrá
Ana
A
D001794:Blood Pressure; D001811:Blood Volume Determination; D006801:Humans; D019095:Point-of-Care Systems; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000503:physiopathology*