Mechanical Ventilation and Lung Mechanics

  • B. Jonson
Conference paper


Classical studies by von Neergaard in 1929 and Radford and co-workers in the early 1960’s showed in experiments with liquid- and air-filled lungs that surface forces are responsible for a large part of the elastic recoil pressure of the lungs [1, 2]. Concepts which may form the basis for the interpretation of elastic pressure-volume (Pel-V) curves in today’s intensive care units were laid down. This interpretation is, however, more complex than has previously been understood as will be emphasised in this chapter. The technique for clinical determination of the Pel-V curves is another issue that will be discussed.


Acute Lung Injury Respir Crit Adult Respiratory Distress Syndrome Lung Mechanic Lung Model 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Neergaard KV (1929) Neue Auffassungen über einen Grundbegriff der Atemmechanik: Die Retraktionskraft der Lunge abhängig von der Oberflächenspannung in den Alveolen. Z Ges Exp Med 66:373–394CrossRefGoogle Scholar
  2. 2.
    Radford EP Jr (1964) Mechanical properties of mammalian lungs. In: Fenn WO, Rahn H (eds) Handbook of physiology. American Physiological Society, Washington DC, pp 429–449Google Scholar
  3. 3.
    Svantesson C, John J, Taskar V et al (1996) Respiratory mechanics in rabbits ventilated with different tidal volumes. Respir Physiol 106:307–316PubMedCrossRefGoogle Scholar
  4. 4.
    Paiva M, Yernault JC, Eerdeweghe PV et al (1975) A sigmoid model of the static volume-pressure curve of the human lung. Respir Physiol 23:317–323PubMedCrossRefGoogle Scholar
  5. 5.
    Svantesson C (1997) Respiratory mechanics during mechanical ventilation in health and in disease [dissertation]. Lund University, LundGoogle Scholar
  6. 6.
    Roupie E, Dambrosio M, Servillo G et al (1995) Titration of tidal volume and induced hypercapnia in acute respiratory distress syndrome. Am J Respir Crit Care Med 152:121–128PubMedGoogle Scholar
  7. 7.
    Matamis D, Lemaire F, Harf A et al (1984) Total respiratory pressure-volume curves in the adult respiratory distress syndrome. Chest 86:58–66PubMedCrossRefGoogle Scholar
  8. 8.
    Gattinoni L, Pelosi P, Crotti S et al (1995) Effects of positive end-expiratory pressure on regional distribution of tidal volume and recruitment in adult respiratory distress syndrome. Am J Respir Crit Care Med 151:1807–1814PubMedGoogle Scholar
  9. 9.
    Richard J-C, Jonson B, Straus C et al (1997) Pressure-volume curves in acute respiratory failure recorded from zero and positive end expiratory pressure. Intensive Care Med 23:S21 (abstract)Google Scholar
  10. 10.
    Svantesson C, Sigurdsson S, Larsson A et al (1998) Effects of recruitment of collapsed lung units on the elastic pressure-volume relationship in anaesthetised healthy adults. Acta Anaesthesiol Scand (in press)Google Scholar
  11. 11.
    Rothen HU, Sporre B, Engberg G et al (1993) Re-expansion of atelectasis during general anaesthesia: a computed tomography study. Br J Anaesth 71:788–795PubMedCrossRefGoogle Scholar
  12. 12.
    Suter PM, Fairley HB, Isenberg MD (1978) Effect of tidal volume and positive end-expiratory pressure on compliance during mechanical ventilation. Chest 73:158–162PubMedCrossRefGoogle Scholar
  13. 13.
    Gattinoni L, Mascheroni D, Basilico E et al (1987) Volume/pressure curve of total respiratory system in paralysed patients: artefacts and correction factors. Intensive Care Med 13:19–25PubMedCrossRefGoogle Scholar
  14. 14.
    Dall’Ava-Santucci J, Armaganidis A, Brunet F et al (1988) Causes of error of respiratory pressure-volume curves in paralyzed subjects. J Appl Physiol 64:42–49Google Scholar
  15. 15.
    Gottfried SB, Rossi A, Higgs BD et al (1985) Noninvasive determination of respiratory system mechanics during mechanical ventilation for acute respiratory failure. Am Rev Respir Dis 131:414–420PubMedGoogle Scholar
  16. 16.
    Bates JH, Baconnier P, Milic-Emili J (1988) A theoretical analysis of interrupter technique for measuring respiratory mechanics. J Appl Physiol 64:2204–2214PubMedGoogle Scholar
  17. 17.
    Levy P, Similowski T, Corbeil C et al (1989) A method for studying the static volume-pressure curves of the respiratory system during mechanical ventilation. J Crit Care 4:83–89CrossRefGoogle Scholar
  18. 18.
    Jonson B, Beydon L, Brauer K et al (1993) Mechanics of respiratory system in healthy anesthetized humans with emphasis on viscoelastic properties. J Appl Physiol 75:132–140PubMedGoogle Scholar
  19. 19.
    Beydon L, Svantesson C, Brauer K et al (1996) Respiratory mechanics in patients ventilated for critical lung disease. Eur Respir J 9:262–273PubMedCrossRefGoogle Scholar
  20. 20.
    Svantesson C, Drefeldt B, Jonson B (1997) The static pres sure-volume relationship of the respiratory system determined with a computer-controlled ventilator. Clin Physiol 17:419–430PubMedCrossRefGoogle Scholar
  21. 21.
    Suratt PM, Owens D (1981) A pulse method of measuring respiratory system compliance in ventilated patients. Chest 80:34–38PubMedCrossRefGoogle Scholar
  22. 22.
    Ranieri VM, Giuliani R, Fiore T et al (1994) Volume-pressure curve of the respiratory system predicts effects of PEEP in ARDS: “occlusion” versus “constant flow” technique. Am J Respir Crit Care Med 149:19–27PubMedGoogle Scholar
  23. 23.
    Servillo G, Svantesson C, Beydon L et al (1997) Pressure-volume curves in acute respiratory failure. Automated low flow inflation versus occlusion. Am J Respir Crit Care Med 155: 1629–1636PubMedGoogle Scholar
  24. 24.
    Venegas JG, Harris RS, Simon BA (1998) A comprehensive equation for the pulmonary pressure-volume curve. J Appl Physiol 84:389–395PubMedGoogle Scholar
  25. 25.
    Amato MB, Barbas CS, Medeiros DM et al (1995) Beneficial effects of the “open lung approach” with low distending pressures in acute respiratory distress syndrome. A prospective randomized study on mechanical ventilation. Am J Respir Crit Care Med 152:1835–1846PubMedGoogle Scholar
  26. 26.
    Amato MB, Barbas CS, Medeiros DM et al (1998) Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 338:347–354PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 1999

Authors and Affiliations

  • B. Jonson
    • 1
  1. 1.Dept. of Clinical PhysiologyUniversity Hospital of LundLundSweden

Personalised recommendations