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Critical Care

, 11:P190 | Cite as

Pressure dependency of respiratory resistance in patients with acute lung injury and acute respiratory distress syndrome

  • C Stahl
  • H Knorpp
  • S Schumann
  • D Steinmann
  • K Möller
  • J Guttmann
Poster presentation

Keywords

Lung Injury Respiratory Distress Syndrome Acute Lung Injury Distress Syndrome Acute Respiratory Distress Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

The analysis of the nonlinearity of respiratory compliance to guide ventilator settings in ALI and ARDS is well established. The pressure dependency (or volume dependency respectively) of respiratory resistance of these patients is mostly ignored. This study was performed to investigate the pressure dependency of resistance in ALI and ARDS over a wide range of pressures.

Methods

Twenty-one patients with ALI or ARDS were analyzed. Ventilation was interrupted by a respiratory manoeuvre: the volume was increased from ZEEP in steps of 100 ml with constant inspiratory flow until the plateau pressure reached 45 cmH2O. Each step was followed by a hold of 3 seconds. Inspiratory resistance during each step was determined by a least-squares fitting procedure.

Results

Resistance decreased from 10.7 ± 5.1 cmH2O· s/l at 5 cmH2O to 8.1 ± 4.0 cmH2O· s/l at 40 cmH2O (P < 0.05). Figure 1 shows individual absolute values and means ± SD of all patients. Most of the decrease was found up to 20 cmH2O; at higher pressures, changes were not uniform. The average relative changes in inspiratory resistance (± SD) of all patients are shown in Figure 2.
Figure 1

abstract P5

Figure 2

abstract P28

Conclusion

Inspiratory resistance in ALI and ARDS is not constant. Especially at higher pressures, individual resistance may change unpredictably. The assumption of a constant resistance should therefore be avoided.

Copyright information

© BioMed Central Ltd. 2007

Authors and Affiliations

  • C Stahl
    • 1
  • H Knorpp
    • 1
  • S Schumann
    • 1
  • D Steinmann
    • 1
  • K Möller
    • 1
  • J Guttmann
    • 1
  1. 1.Anästhesiologische UniversitätsklinikFreiburgGermany

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