• M Lichtwarck-Aschoff, V Kessler, U H Sjöstrand, A Hedlund, G Mols, S Rubertsson, A M Markström, and J Guttmann.
• Department of Anesthesiology and Intensive Care, University Hospital, Uppsala, Sweden.
• Br J Anaesth. 2000 Oct 1;85(4):577-86.

AbstractThe lower inflection point (LIP) of the inspiratory limb of a static pressure-volume (PV) loop is assumed to indicate the pressure at which most lung units are recruited. The LIP is determined by a static manoeuvre with a PV-history that is different from the PV-history of the actual ventilation. In nine surfactant-deficient piglets, information to allow setting PEEP and VT was obtained, both from the PV-curve and also during ongoing ventilation from the dynamic compliance relationship. According to LIP, PEEP was set at 20 (95% confidence interval 17-22) cm H2O. Volume-dependent dynamic compliance suggested a PEEP reduction (to 15 (13-18) cm H2O). Pulmonary gas exchange remained satisfactory and this change resulted in reduced mechanical stress on the respiratory system, indirectly indicated by volume-dependent compliance being consistently great during the entire inspiration.

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