- Poster presentation
- Open access
- Published:
Accuracy of the pressure-volume curve method compared to quantitative lung CT scan to assess the recruitable lung in patients with acute respiratory failure
Critical Care volume 16, Article number: P104 (2012)
Introduction
In patients with acute lung injury the knowledge of recruitable lung is useful for a physiological PEEP setting. The quantitative lung CT scan analysis remains the reference method [1]. However, it is time consuming and often it is not applicable in clinical management. The PV curve at two PEEP levels has been proposed as an alternative method [2]. The aim of this study was to evaluate the accuracy of these two methods in predicting the lung recruitability.
Methods
Sedated and paralyzed patients underwent a PV curve using the low-flow method and whole-lung CT scan at 5 and 15 cmH2O of PEEP. The lung recruitability was defined as the decrease in the not aerated tissue by the quantitative lung CT analysis and as the difference between the lung volume computed on the two PV curves for an airway pressure of 20 cmH2O.
Results
Ten patients (mean age 65.4 ± 10.4 years, body mass index 24.0 ± 6.8 kg/m2, PaO2/FiO2 181 ± 37) were enrolled. The mean recruitable lung was 3.9 ± 6.3% of the total lung weight and 218 ± 266 ml for the quantitative lung CT scan and PV curve. The linear regression between the two methods (Figure 1) was not significant (P = 0.338 and R2 = 0.115).
Linear regression between quantitative CT scan analysis and PV curve method.
Conclusion
The recruitable lung computed as the difference in not aerated tissue was not related to the difference in volume estimated by the PV curve. The role of the PV curve to estimate the lung recruitability remains to be elucidated.
References
Gattinoni L, et al.: Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med 2006, 354: 1775-1786. 10.1056/NEJMoa052052
Ranieri VM, et al.: Volume-pressure curve of the respiratory system predicts effects of PEEP in ARDS: 'occlusion' versus 'constant flow' technique. Am J Respir Crit Care Med 1994, 149: 19-27.
Author information
Authors and Affiliations
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Chiumello, D., Marino, A., Cigada, I. et al. Accuracy of the pressure-volume curve method compared to quantitative lung CT scan to assess the recruitable lung in patients with acute respiratory failure. Crit Care 16 (Suppl 1), P104 (2012). https://doi.org/10.1186/cc10711
Published:
DOI: https://doi.org/10.1186/cc10711