and mean airway pressure didn't have significant difference between two groups but peak airway pressure in 35 and 55 minutes after pneumoperitoneum was significantly higher in VCV group than PCV group (P<0.
6 (%, mean [+ or -] SD) Plateau pressure
[greater than or 28.
Unless the clinician has eliminated patient effort, (s)he cannot feel entirely comfortable about a plateau pressure
in the 20's.
The table 12 & Fig 10 shows mean & standard deviation of baseline peak & plateau pressure
for pressure controlled and volume controlled ventilation which shows that peak & plateau pressure
was less for pressure controlled ventilation compared with volume controlled ventilation.
Such an approach was recently examined in the Permissive Hypercapnia, Alveolar Recruitment and Limited Airway Pressures (PHARLAP) trial; individualised PEEP titration and targeted plateau pressures
resulted in improved oxygenation, pulmonary compliance and reduced expression of inflammatory cytokines.
2) However, it was only in 2000 when the ARMA study published by the ARDS Network provided recommendations for low-volume mechanical ventilation (6 ml/kg) and airway plateau pressures
under 30 cm [H.
Additionally as long as tidal volume during mechanical ventilation does not go beyond 10 ml/kg and the plateau pressure
does not go beyond 30-35 cm water, alveolar rupture almost never occurs.
Total static compliance of the respiratory system was calculated as: static compliance = tidal volume/(airway plateau pressure
- positive end-expiratory pressure).
This ventilatory strategy is generally implemented when the plateau pressure
(alveolar pressure) climbs to potentially dangerous levels.
The Evita XL ventilator will provide plateau pressure
data in SIMV without autoflow mode, however because our current clinical practice is to use SIMV with autoflow, plateau pressure
data was not available.
The measurement of Plateau Pressure
(PPLAT) is one of the most indispensable values we can determine.
In the pressure-time curves at Y-piece of the PB840, plateau pressure
(Ppl) in the injured model (18.
- (PPLAT) PPLAT is the pressure measured at the end of inspiration during an inflation hold.
Several of the key elements to patient management include: 1) During mechanical ventilation, target tidal volume at 6mL/Kg per ideal body weight or less, 2) maximize plateau pressure
at 30 cm H20 or less to prevent volume induced lung injury, 3) allow for permissive hypercapnia to achieve the pressure and volume targets, 5) set PEEP to avoid alveolar collapse since alveolar de-recruitment leads to high alveolar opening pressures and lung damage, 6) minimize the use of pulmonary artery catheters due to no evidence based benefit, 6) use bicarbonate therapy if pH is < 7.