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Respiratory system compliance and resistance in the critically ill 

Respiratory system compliance and resistance in the critically ill
Respiratory system compliance and resistance in the critically ill

Ricardo Luiz Cordioli

and Laurent Brochard

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date: 25 February 2020

Under mechanical ventilation, monitoring of respiratory mechanics is fundamental, especially in patients with abnormal mechanics. In order to appropriately set the ventilator, clinicians need to understand the relationship between pressure, volume and flow. To move air in and out the thorax, energy must be dissipated against elastic and resistive forces. Elastance is the pressure to volume ratio and necessitates an end inspiratory occlusion to measure the so-called plateau pressure. Resistance is the ratio between pressure dissipated and mean gas flow. Finally, the total positive end expiratory pressure must be measured with an end expiratory occlusion. Volume-controlled ventilation is the recommended mode to assess respiratory mechanics of a passive patient. Clinicians must be aware that both chest wall and lung participate in forces imposed by the respiratory system. An oesophageal catheter can estimate pleural pressure, and used to partition the respective role of the lung and the chest wall.

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