Although ventilation with small tidal volumes is recommended in patients with established acute lung injury, most others receive highly variable tidal volume aimed in part at normalizing arterial blood gas values. We tested the hypothesis that acute lung injury, which develops after the initiation of mechanical ventilation, is associated with known risk factors for ventilator-induced lung injur...

Recent studies have shown that application of the ARDSNet low tidal volume strategy (i.e. allowing an increase in respiratory rate in order to minimize hypercapnia in those with low tidal volume) may generate consistent auto-PEEP (positive end-expiratory pressure), and this is not efficient in improving clearance of carbon dioxide. The present commentary deals with some of the recent controvers...

INTRODUCTION The most appropriate tidal volume in patients without acute respiratory distress syndrome (ARDS) is controversial and has not been rigorously examined. Our objective was to determine whether a mechanical ventilation strategy using lower tidal volume is associated with a decreased incidence of progression to ARDS when compared with a higher tidal volume strategy. METHODS A systema...

It is well recognised that reducing positive end expiratory pressure (PEEP) leads to an increase in the tidal volume and minute volume in ventilated neonates. The magnitude of this effect is perhaps not commonly appreciated, however. Effectively, PEEP is four times as potent as peak inflation pressure (PIP) in bringing about changes in tidal volume. The influence of changes in PEEP and PIP on t...

After bronchoconstriction, deep inspiration (DI) causes dilatation followed by airway re-narrowing. Re-narrowing may be faster in asthmatic than nonasthmatic subjects. This study investigated the relationship between re-narrowing and the magnitude of both DI-induced dilatation and the volume-dependence of respiratory system resistance (Rrs) during tidal breathing. In 25 asthmatic and 18 nonasth...

1. Recordings were made of the pattern of breathing during and after smoking a cigarette in 14 smokers and nine non-smokers. 2. The most consistent effect was an increase in tidal volume during smoking which reverted to baseline over 1-2 min. Changes in breath times were smaller and less consistent. Similar effects were observed with intermittent inhalations of charcoal. 3 In four subjects the ...

BACKGROUND Adaptive support ventilation (ASV) allows the clinician to set a maximum plateau pressure (PP) and automatically adjusts tidal volume to keep PP below the set maximum. METHODS ASV was compared to a fixed tidal volume of 6 ml/kg. ASV determined the respiratory rate and tidal volume based on its algorithms. Maximum airway pressure limit was 28 cm H2O in ASV. Six sets of lung mechanic...

During mechanical ventilation in small animals a discrepancy between tidal volume applied through a piston ventilator and the measured volume displacement of the thorax occurs. Such differences, which can be as large as (10-30 %) depend on the mechanical properties of the lungs and thorax, as well as the volume and resistance of the tubing system. In this study we evaluate an adaptive controlle...