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The relationships between Clung, Cscan and CEIT were performed by using the coefficients of determination over the 10 PEEP steps in each pig. iii) by computing ratio of change in electrical impedance to driving pressure (CEIT). ii) by using CT data (Cscan) as ratio of tidal volume (sum of the difference between inspiration and expiration in volume of normally aerated, poorly aerated and overaerated lung compartments) to driving pressure (plateau pressure minus PEEP). Compliance was inferred using three methods: i) by fitting a R-C model on recorded pressure and flow signals using a least square method (Clung). At each PEEP step, airway pressure, esophageal pressure and airflow were acquired (Biopac 100), whole lung CT scan was performed during end-expiratory and end-inspiratory pause, and finally electrical impedance tomography (EIT) (Göttingen University) signal was acquired. PEEP was initially set to 20 cmH2O then decreased by 2 cmH2O-steps lasting 2 minutes each to 2 cmH2O.
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Once PaO2 was lower than 100 mmHg under 100% FIO2, a recruitment manoeuver (sustained inflation to 40 cm H2O for 30 seconds) was performed followed by cycling mechanical ventilation in volume controlled mode, constant flow inflation, 100% FIO2, tidal volume 6 ml/kg body weight, respiratory rate 35 breaths/min. Female piglets were anesthetized, paralyzed, tracheotomized and mechanically ventilated (Carestation, GE Healthcare) and acute lung injury was performed by saline lavage. To compare three methods to measure lung compliance and to find out which is associated with the optimal PEEP (maximal compliance) during a decremental PEEP trial. This latter can be defined from different variables, lung compliance being one of them.
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MODS EMERGENCY 4 EDICION ORO TRIAL
Decremental PEEP trial after a recruitment manoeuver is an attractive method to detect optimal PEEP. PEEP is by nature an expiratory setting aiming at maintaining lung recruitment reached during the breathing cycle and/or during a recruitment manoeuver. Optimal PEEP is still a matter of debate in ARDS patients. Richard Intensive Care Medicine Experimental 2017, 5(Suppl 2):0001 INTRODUCTION. Guérin1,2 1 Hopital de la Croix Rousse, Lyon, France 2IMRB INSERM 955, Créteil, France Correspondence: J.-C. Oral Sessions Monday, 25 September 2017 Acute respiratory failure and MV experimental studies 0001 Comparison of three methods to measure lung compliance during a decremental PEEP trial in an experimental model of ARDS J.-C. Intensive Care Medicine Experimental 2017, 5(Suppl 2):44 DOI 10.1186/s4063-4ĮSICM LIVES 2017 30th ESICM Annual Congress.