Etween the area of the P curves as well as the item of maximal volume by maximal stress. Even contemplating thermodynamics and gas exchange correction, Vgas values have been systematically greater than Vcw in all probability as a result of blood shifts from the thorax for the extremities. As a consequence, the typical supersyringe system offers an overestimation of thePDiscrepancy Crsinf (ml) (ml/cmH2O) Pvgas PVcw 130 ?83 ?66 ?21* 59 ?Crs def (ml/cmH2O) 63 ?21* 58 ?Hysteresis ( ) 19.2 ?5.9* 15.2 ?5.The data are expressed as imply D.* Paired t-test P < 0.05 vs PVCW.inspiratory and expiratory compliance of the total respiratory system on the inflation limb and an overestimation of the hysteresis area. Volumes and pressures were measured using CP-100 pulmonary monitor (BICORE monitoring systems, USA) at the end of airway. Estimated lung recruitment ELR (ELRPEEPtest = EELVPEEPtest ?CrsPEEPtest x [PEEPtest ?PEEPbaseline]) was calculated for each tested level of PEEP. Ability to predict the PEEP level with minimal shunt was tested for minimal PEEP with maximal Crs, for maximal PEEP with maximal Crs and for algorithm based on static compliance and the amount of estimated lung recruitment. Sensitivity, specificity and likelihood ratio (LR) for prediction of PEEP level with minimal shunt were calculated, Fisher exact test was used for statistical analysis, P < 0.05* was considered statistically significant. Results:Sensitivity Maximal PEEP with maximal Crs Minimal PEEP with maximal Crs Minimal PEEP with ELR > ELRmax ?150 ml and maximal Crs 0.143 0.571 0.857* Specificity 0.7 0.850 0.95 LR 0.4 three.8 17.Conclusion: In spite of limited number of individuals and feasible influence of utilised equipment on important worth of ELR we discovered that combined assessment of compliance and recruited lung volume enables much better prediction of PEEP setting with minimal Qs/Qt. Reference:1. Gattinoni L et al: Am J Respir Crit Care Med 1995, 151:1807?814.PPositive end-expiratory stress doesn’t improve intraocular pressure in sufferers with intracranial pathologyK Kokkinis*, P Manolopoulou*, J Katsimpris, S Gartaganis *Department of Anaesthesiology and Crucial Care Medicine, and Department of Ophthalmology, University Hospital of Patras, Patras, Greece Introduction: Mechanical ventilation with PEEP is the cornerstone of remedy of individuals with ALI and ARDS, nevertheless it is not totally free of adverse effects. This study aims to examine the impact of varying MedChemExpress ML-18 levels of PEEP on the intraocular pressure in critically ill patients with intracranial pathology. Supplies and strategies: We studied 40 patients with intracranial pathology and respiratory failure, with out history of glaucoma and not getting drugs recognized to influence intraocular pressure. Twentyone sufferers had head injury (GCS eight on admission), 11 had subarachnoid hemorrhage (III-IV Hunt and Hess) and eight had intracerebral hemorrhage. Measurement of intraocular pressures where done although the sufferers have been mechanically ventilated with different levels of PEEP. These patients were divided in 4 groups (A, B, C, D) of 10 individuals. Every single group had different PEEP values according to the attending doctor for at the very least > 24 hours (see Table). Imply systemic arterial stress, peak airway stress, central venous PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20718733 stress and arterial oxygen saturation had been recorded (see Table).We hypothesized that because of collapse tendency 1) the effect of a lung recruitment maneuver (LR) on a stress bsolute lung volume (P ) curve would be minimal, 2) but if LR is followed quickly.
