Effects of Positive End-Expiratory Pressure and Different Tidal Volumes on Alveolar Recruitment and Hyperinflation

What Has Computed Tomography Taught Us about the Acute Respiratory Distress Syndrome?

“…Numerically, most authors define four lung compartments: hyperinflated, normally aerated, poorly aerated, and nonaerated. The HU limits of these compartments vary slightly from investigator to investigator (2,(30)(31)(32)(33)(34)(35) (Table 1).…”

Lung recruitment during mechanical positive pressure ventilation in the PICU: what can be learned from the literature?

“…Higher inspiratory and expiratory pressures are needed to open and stabilise these collapsed alveoli, and the increased inhomogeneity is reflected in different opening, over-distension and collapse pressures within the lung [19][20][21]. The upper inflection point on the pressurevolume loop is related to alveolar over-distention, usually at pressures well over 30-50 cm H 2 O [22,23]. The lower inflection point (LIP) is not related to alveolar opening or optimal recruitment or 'optimal PEEP' as it is merely a result of external factors such as chest wall compliance and intra-abdominal pressure, and the recruitment state as a result of volume history [22,[24][25][26][27][28].…”

CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

“…Compared with children who did not have the maneuver performed, the mere application of 5 cm H 2 O of CPAP without a prior recruitment did not show the same treatment effect and showed no difference compared to the control group without PEEP [10]. It is also important to note that while using high inflating pressures is benign in most cases, high-pressure ventilatory strategies can lead to hemodynamic compromise and possibly cause lung injury from over-distension of non-collapsed lung areas [11,12]. The possibility of these risks from high airway pressures has to be balanced against the benefit of the study.…”