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Reinterpreting the pressure-volume curve in patients with acute respiratory distress syndrome

Hickling, Keith G. MD

Current Opinion in Critical Care: February 2002 - Volume 8 - Issue 1 - p 32-38
Respiratory system

New evidence requires a reinterpretation of the inflation pressure-volume curve and suggests that neither the lower nor the upper inflection point provides reliable information to determine safe ventilator settings in the acute respiratory distress syndrome. Recruitment probably continues throughout the inflation pressure-volume curve, and studies of the deflation pressure-volume curve, reinflations after partial deflation, or decremental positive end-expiratory pressure trials after a recruitment maneuver are probably needed to determine open-lung positive end-expiratory pressure.

Department of Intensive Care, Gold Coast Hospital, Southport, Queensland, Australia.

Correspondence to Keith G. Hickling, MD, Department of Intensive Care, Gold Coast Hospital, Nerang Street, Southport, Queensland 4215, Australia; e-mail:

© 2002 Lippincott Williams & Wilkins, Inc.