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Mechanical Ventilation PV Curves. Techniques for Measurement 1. Supersyringe 2. Constant Flow 3. Multiple Occlusion.

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Presentation on theme: "Mechanical Ventilation PV Curves. Techniques for Measurement 1. Supersyringe 2. Constant Flow 3. Multiple Occlusion."— Presentation transcript:

1 Mechanical Ventilation PV Curves

2 Techniques for Measurement 1. Supersyringe 2. Constant Flow 3. 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” conditions 1 1 Qin Lu, AJRCCM 1999;159: Servillo, AJRCCM 1997;155:

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

5 Gattinoni, ARRD 1987;136: Pflex

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

7 PV Curve Normal ARDS COPD

8 Normal

9 ARDS

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

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

12 Preventing Overdistention and Under-Recruitment Injury “Lung Protective” Ventilation VOLUMEVOLUME VOLUMEVOLUME Pressure Limit Distending Pressure Add PEEP Limit VT

13 PV Curve COPD


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