Setting positive end-expiratory pressure: using the pressure-volume curve

被引:5
作者
Mojoli, Francesco [1 ,2 ,3 ]
Pozzi, Marco [2 ]
Arisi, Eric [2 ]
机构
[1] Univ Pavia, Dept Clin Surg Diagnost & Pediat Sci, Unit Anesthesia & Intens Care, Pavia, Italy
[2] Fdn IRCCS Policlin S Matteo, Anesthesia & Intens Care, Pavia, Italy
[3] Fdn IRCCS Policlin S Matteo, SC Anestesia & Rianimaz 1,DEA Piano 1,Viale Golgi, I-27100 Pavia, Italy
关键词
mechanical ventilation; positive end-expiratory pressure; pressure-volume curve; recruitability; ventilator-induced lung injury; ACUTE RESPIRATORY-DISTRESS; LOWER INFLECTION POINT; INDUCED LUNG INJURY; TIDAL VOLUME; TIME CURVE; MECHANICAL VENTILATION; AUTOMATED-METHOD; PULMONARY-EDEMA; FLOW INFLATION; RECRUITMENT;
D O I
10.1097/MCC.0000000000001127
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose of reviewTo discuss the role of pressure-volume curve (PV curve) in exploring elastic properties of the respiratory system and setting mechanical ventilator to reduce ventilator-induced lung injury.Recent findingsNowadays, quasi-static PV curves and loops can be easily obtained and analyzed at the bedside without disconnection of the patient from the ventilator. It is shown that this tool can provide useful information to optimize ventilator setting. For example, PV curves can assess for patient's individual potential for lung recruitability and also evaluate the risk for lung injury of the ongoing mechanical ventilation setting.SummaryIn conclusion, PV curve is an easily available bedside tool: its correct interpretation can be extremely valuable to enlighten potential for lung recruitability and select a high or low positive end-expiratory pressure (PEEP) strategy. Furthermore, recent studies have shown that PV curve can play a significant role in PEEP and driving pressure fine tuning: clinical studies are needed to prove whether this technique will improve outcome.
引用
收藏
页码:35 / 42
页数:8
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