Open AccessVolume-Independent Elastance
Author(s) -
Alysson R. Carvalho,
Bruno Curty Bergamini,
Niedja S. Carvalho,
Viviane Ramos Cagido,
Alcendino Cândido Neto,
Frederico C. Jandre,
Walter A. Zin,
Antonio Giannella-Neto
Publication year - 2013
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/ane.0b013e31824a95ca
Subject(s) - medicine , elastance , volume (thermodynamics) , respiratory system , thermodynamics , physics
A decremental positive end-expiratory pressure (PEEP) trial after full lung recruitment allows for the adjustment of the lowest PEEP that prevents end-expiratory collapse (open-lung PEEP). For a tidal volume (Vt) approaching zero, the PEEP of minimum respiratory system elastance (PEEP(minErs)) is theoretically equal to the pressure at the mathematical inflection point (MIP) of the pressure-volume curve, and seems to correspond to the open-lung PEEP in a decremental PEEP trial. Nevertheless, the PEEP(minErs) is dependent on Vt and decreases as Vt increases. To circumvent this dependency, we proposed the use of a second-order model in which the volume-independent elastance (E1) is used to set open-lung PEEP.