Etween the area from the P curves and also the solution of MSC2530818 cost maximal volume by maximal pressure. Even considering thermodynamics and gas exchange correction, Vgas values had been systematically greater than Vcw possibly as a result of blood shifts in the thorax to the extremities. As a consequence, the standard supersyringe system offers an overestimation of thePDiscrepancy Crsinf (ml) (ml/cmH2O) Pvgas PVcw 130 ?83 ?66 ?21* 59 ?Crs def (ml/cmH2O) 63 ?21* 58 ?Hysteresis ( ) 19.2 ?five.9* 15.2 ?5.The information are expressed as imply D.* Paired t-test P < 0.05 vs PVCW.inspiratory and expiratory compliance of the total respiratory system on the inflation limb and an overestimation of the hysteresis area. Volumes and pressures were measured using CP-100 pulmonary monitor (BICORE monitoring systems, USA) at the end of airway. Estimated lung recruitment ELR (ELRPEEPtest = EELVPEEPtest ?CrsPEEPtest x [PEEPtest ?PEEPbaseline]) was calculated for each tested level of PEEP. Ability to predict the PEEP level with minimal shunt was tested for minimal PEEP with maximal Crs, for maximal PEEP with maximal Crs and for algorithm based on static compliance and the amount of estimated lung recruitment. Sensitivity, specificity and likelihood ratio (LR) for prediction of PEEP level with minimal shunt were calculated, Fisher exact test was used for statistical analysis, P < 0.05* was considered statistically significant. Results:Sensitivity Maximal PEEP with maximal Crs Minimal PEEP with maximal Crs Minimal PEEP with ELR > ELRmax ?150 ml and maximal Crs 0.143 0.571 0.857* Specificity 0.7 0.850 0.95 LR 0.4 three.8 17.Conclusion: Despite restricted quantity of patients and attainable influence of made use of gear on critical value of ELR we located that combined assessment of compliance and recruited lung volume enables far better prediction of PEEP setting with minimal Qs/Qt. Reference:1. Gattinoni L et al: Am J Respir Crit Care Med 1995, 151:1807?814.PPositive end-expiratory stress doesn’t raise intraocular pressure in sufferers with intracranial pathologyK Kokkinis*, P Manolopoulou*, J Katsimpris, S Gartaganis *Department of Anaesthesiology and Essential Care Medicine, and Division of Ophthalmology, University Hospital of Patras, Patras, Greece Introduction: Mechanical ventilation with PEEP is definitely the cornerstone of remedy of patients with ALI and ARDS, however it is just not no cost of adverse effects. This study aims to examine the impact of varying levels of PEEP on the intraocular pressure in critically ill individuals with intracranial pathology. Components and methods: We studied 40 individuals with intracranial pathology and respiratory failure, devoid of history of glaucoma and not receiving drugs known to affect intraocular stress. Twentyone individuals had head injury (GCS eight on admission), 11 had subarachnoid hemorrhage (III-IV Hunt and Hess) and eight had intracerebral hemorrhage. Measurement of intraocular pressures exactly where carried out even though the individuals have been mechanically ventilated with distinct levels of PEEP. These individuals have been divided in 4 groups (A, B, C, D) of ten individuals. Every single group had diverse PEEP values according to the attending physician for at the least > 24 hours (see Table). Mean systemic arterial stress, peak airway stress, central venous PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20718733 stress and arterial oxygen saturation have been recorded (see Table).We hypothesized that as a consequence of collapse tendency 1) the impact of a lung recruitment maneuver (LR) on a stress bsolute lung volume (P ) curve could be minimal, 2) but if LR is followed straight away.