• Luca Bastia, Liliana Amendolagine, Federico Pozzi, Stefano Carenini, Cristiana Cipolla, Francesco Curto, Giacomo Bellani, Roberto Fumagalli, and Arturo Chieregato.
• Neurointensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
• Crit. Care Med. 2023 Oct 1; 51 (10): e201e205e201-e205.

ObjectivesTo compare respiratory system compliance (C rs ) calculation during controlled mechanical ventilation (MV) and, subsequently, during assisted MV.DesignThis is a single-center, retrospective, observational study.SettingThis study was conducted on patients admitted to Neuro-ICU of Niguarda Hospital (tertiary referral hospital).PatientsWe analyzed every patient greater than or equal to 18 years old having a C rs measurement in controlled and in assisted MV within 60 minutes. Plateau pressure (P plat ) was considered reliable if it was deemed visually stable for at least 2 seconds.InterventionsInspiratory pause was incorporated to detect P plat in controlled and assisted MV. Calculation of C rs and driving pressure were achieved.Measurements And Main ResultsA total of 101 patients were studied. An acceptable agreement was found (Bland-Altman plot bias -3.9, level of agreement upper 21.6, lower -29.6). C rs in assisted MV was 64.1 (52.6-79.3) and in controlled MV it was 61.2 (50-71.2) mL/cm H 2o ( p = 0.006). No statistical difference was found in C rs (assisted vs controlled MV) when peak pressure was lower than P plat nor when peak pressure was higher than P plat .ConclusionsA P plat visually stable for at least 2 seconds leads to reliable C rs calculation during assisted MV.Copyright © 2023 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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