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Compliance curves or pressure-volume curves in acute respiratory fail

The goal of this paper is to review the use of pressure-volume (P-V) curves or compliance curves in patients with acute respiratory failure (ARF) - acute lung injury (ALI), and acute respiratory distress syndrome (ARDS). The most important papers published in English language literature concerning P-V curves in ARF were found in Medline and reviewed. Ideally, recommendation is made to calculate P-V curves in all patients with ARF in order to achieve adequate monitoring and management considering data obtained from the curves, such as lower inflexion point, upper inflexion point, and static compliance. The methods used to obtain P-V curves are supersyringe, multiple inspiratory occlusions and continuous flow. All of them are similar if low continuous flow is used and if care is taken to allow lung emptying and to avoid intrinsic PEEP (positive end expiratory pressure) before accomplishing the curves. In this way continuous flow can be a simple, inexpensive, secure and reliable method to be carried out at bedside in order to obtain P-V curves that allow for a better monitoring and management of patients with ARF.

Acute lung injury; Acute respiratory distress syndrome; Pressure-volume curves; Static compliance; Lower inflexion point; Upper inflexion point


Sociedade Brasileira de Pneumologia e Tisiologia Faculdade de Medicina da Universidade de São Paulo, Departamento de Patologia, Laboratório de Poluição Atmosférica, Av. Dr. Arnaldo, 455, 01246-903 São Paulo SP Brazil, Tel: +55 11 3060-9281 - São Paulo - SP - Brazil
E-mail: jpneumo@terra.com.br