Plateau and Transpulmonary Pressure With Elevated Intra-Abdominal Pressure or Atelectasis

The chest wall

“…Why, a plateau pressure of 28-30 cm H 2 O in these patients does not reflect the same level of over distension as observed in patients with normal chest wall mechanics (6)(7)(8). An end-inspiratory plateau pressure of the respiratory system of 30 cm H 2 O reflected a transpulmonary pressure of 10-28 cm H 2 O, consistent with data provided by Kubiak et al (9) in general surgical patients and Behazin et al (10) in obese surgical patients. Chiumello et al (6) and Grasso et al (8) have clearly demonstrated the inability of the end-inspiratory plateau pressure of the respiratory system to identify over distension in patients with increased chest wall elastance.…”

Pleural Pressure and Optimal Positive End-Expiratory Pressure Based on Esophageal Pressure Versus Chest Wall Elastance

“…In other words, when one uses the change in P or P to o es ao determine .E^^ or E^^ and then to estimate P, or P^, one is assuming that the chest wall and respiratory system P-y curves are linear. Previous studies, however, have shown that this assumption is not always valid (13,(19)(20)(21)(22). Assuming a linear P-y curve could lead to inaccuracies in the estimated .E^,^ and Ppi.…”

Effects of different ventilation strategies on lung injury in newborn rabbits

“…The juxtaposition of open and closed respiratory units amplifies the strain at their interfaces 19. There are abundant data focusing on the effect of plateau pressure (P plat ) on the prevention of VILI 20, 21. The P plat is the pressure applied to the small airways and alveoli, and in positive pressure ventilation, it reflects the alveoli resistance and is an immediate cause of VILI 20, 21.…”