Effects of PEEP on inspiratory and expiratory mechanics in adult respiratory distress syndrome

• Published in: Respiratory medicine 2003-02, Vol.97 (2), p.159-166
• Main Authors: FRANTZESKAKI, F, AMYGDALOU, A, RASMUSSEN, T.R, VASSILIOU, M.P, BEHRAKIS, P.K
• Format: Article
• Language: English
• Subjects: Adult respiratory distress syndrome; Biological and medical sciences; Case-Control Studies; Elasticity; Female; Humans; Male; Medical sciences; Middle Aged; multiple linear regression analysis; Pneumology; positive end-expiratory pressure; Positive-Pressure Respiration - methods; Regression Analysis; Respiratory Distress Syndrome, Adult - physiopathology; Respiratory Distress Syndrome, Adult - therapy; respiratory mechanics; Respiratory Mechanics - physiology
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1053/rmed.2003.1421

The purpose of the present study was to assess the mechanical behavior of the respiratory system separately during inspiration and expiration in adult respiratory distress syndrome (ARDS) and the influence of PEEP on any phasic variations of the mechanical respiratory parameters. Airways pressure ( P), flow ( V′), and volume ( V) signals were recorded in nine patients with ARDS and 10 patients without known respiratory disorder (control group). All patients were artificially ventilated at three levels of positive end-expiratory pressure (PEEP): 0, 5, and 10 hPa. Data were analyzed separately for inspiratory and expiratory records using multiple linear regression analysis (MLRA) according to the equation: P=Ers V+Rrs V′+ P 0, where Ers and Rrs represent, respectively, the intubated respiratory system elastance and resistance, and P 0 the end-expiratory pressure. In the ARDS group expiratory Ers (Ers EXP=45.58±4.24 hPa/L) was substantially higher ( p