Erschienen in:
02.04.2024 | Editorial
Detecting end-tidal hyperinflation
verfasst von:
John J. Marini
Erschienen in:
Intensive Care Medicine
|
Ausgabe 5/2024
Einloggen, um Zugang zu erhalten
Excerpt
The series-coupled lung and its enclosure, the chest wall (CW), are expanded in tandem by the airway pressure (Paw) that inflates them both. Consequently, alveolar distention is a function of trans-pulmonary pressure (Ptp), which is affected not only by measured airspace pressures but also by gravitational forces, local CW compliance, spontaneous effort, physical habitus, and body position. Clinicians seldom measure the pleural pressure or unstressed gas volume (FRC). Yet, both are key components of the end-tidal pressures developed during acute respiratory distress syndrome (ARDS), in which the available airspace at FRC (termed the ‘baby lung’) is greatly reduced. Numerical guidelines for safe driving and plateau pressures monitored in the ventilator circuit are quite helpful but prove insufficient in gauging the extent and severity of regional lung stretch. …
