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Mechanical Ventilation PV Curves

Mechanical Ventilation PV Curves. Techniques for Measurement. Supersyringe Constant Flow Multiple Occlusion. Low Constant Flow. Simple Can be performed on ventilator (some types) Avoids disconnect Hysteresis Heavy sedation or paralysis required

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Mechanical Ventilation PV Curves

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  1. Mechanical Ventilation PV Curves

  2. Techniques for Measurement • Supersyringe • Constant Flow • Multiple Occlusion

  3. Low Constant Flow • Simple • Can be performed on ventilator (some types) • Avoids disconnect • Hysteresis • Heavy sedation or paralysis required • Flow  9 L/min for “quasi-static” conditions1 1Qin Lu, AJRCCM 1999;159:275-282 Servillo, AJRCCM 1997;155:1629-1636

  4. Surface forces due to air-liquid interface Radford, Tissue Elasticity, 1957

  5. Pflex Gattinoni, ARRD 1987;136:730-736

  6. Pressure-Volume Curve zone of overdistension V UIP zone of derecruitment and atelectasis "safe" window LIP P

  7. PV Curve ARDS COPD Normal

  8. PV Curve Normal

  9. PV Curve ARDS

  10. Lung Protective Ventilator Strategies volutrauma zone of overdistension V UIP DON’T EVEN THINK OF PARKING HERE zone of derecruitment and atelectasis "safe" window LIP atelectrauma P

  11. PV Curve in ARDS Upper Pflex, UIP Overdistention Volume Lower Pflex, LIP Safe zone Derecruited Pressure

  12. Add PEEP Limit Distending Pressure Limit VT Preventing Overdistention and Under-Recruitment Injury “Lung Protective” Ventilation V O L U M E Pressure

  13. PV Curve COPD

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