Figure 2
From: Respiratory effects of different recruitment maneuvers in acute respiratory distress syndrome
Pressure-time and flow-time curves of a representative patient with a lower inflection point at 11 cm H2O and an upper inflection point (UIP) at 39 cm H2O. This patient was randomly assigned to benefit from extended sigh (eSigh) first. Initially, positive end-expiratory pressure (PEEP) was set at 14 cm H2O and tidal volume (VT) at 480 mL. During eSigh, PEEP was increased to 21 cm H2O. Plateau pressure was higher than UIP, so VT was decreased to 390 mL for 15 minutes. After an 80-minute period (Figure 1), the second recruitment maneuver (RM) (continuous positive airway pressure [CPAP]) was performed at 40 cm H2O for 40 seconds. After this second RM, PEEP was set at 14 cm H2O. On the flow-time curve, we can see two large expiratory cycles after both RMs corresponding to RM-induced changes in end-expiratory lung volume.