Impairment of lung and chest wall mechanics in patients with acute respiratory distress syndrome: role of abdominal distension.

@article{Ranieri1997ImpairmentOL,
  title={Impairment of lung and chest wall mechanics in patients with acute respiratory distress syndrome: role of abdominal distension.},
  author={Vito Marco Ranieri and Nicola Brienza and Silvia Santostasi and Filomena Puntillo and Luciana Mascia and Nicola Vitale and Rocco Giuliani and Vincenzo Memeo and Francesco Bruno and Tommaso Fiore and A. Brienza and Arthur S Slutsky},
  journal={American journal of respiratory and critical care medicine},
  year={1997},
  volume={156 4 Pt 1},
  pages={
          1082-91
        }
}
Recent data have suggested that the elastic properties of the chest wall (CW) may be compromised in patients with ARDS because of abdominal distension (4). We partitioned CW and lung (L) mechanics, assessed the role of abdominal distension, and verified whether the underlying disease responsible for ARDS affects the impairment of respiratory mechanics. Volume-pressure (V-P) curves (interrupter technique) were assessed in nine patients with surgical ARDS and nine patients with medical ARDS… 
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The chest wall in acute lung injury/acute respiratory distress syndrome
TLDR
As chest wall compliance may have important clinical implications during positive-pressure ventilation, the physiology of this effect should be considered, particularly in patients with acute lung injury and increased abdominal pressure.
Method and Interpretation of the Pressure Volume Curve in Patients With Acute Respiratory Distress Syndrome
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The interpretation and the utility of the pressure volume curve should, therefore, be reconsidered in the light of recent knowledge.
Respiratory mechanics in ARDS
TLDR
The role of compliance and resistance of the total respiratory system in ARDS patients is investigated, but only few studies separately considered the relative contributions of the lung and the chest wall.
Effect of the chest wall on pressure–volume curve analysis of acute respiratory distress syndrome lungs*
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This method of “correcting” the total respiratory system P-V curve for the chest wall allows for calculation of an airway pressure that would place the lung at a desired volume on its P- V curve.
Measurement and Interpretation of Lung Mechanics in Patients with Acute Respiratory Failure
TLDR
In this chapter, the static mechanical properties of the respiratory system at zero end-expiratory pressure (ZEEP) and at positive end-injury pressure (PEEP), their methods of measurement, and their interpretation will be discussed.
Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease. Different syndromes?
TLDR
The different respiratory mechanics and response to PEEP observed are consistent with a prevalence of consolidation in ARDSp as opposed to prevalent edema and alveolar collapse in ARDSexp.
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TLDR
Although extensively proposed to tailor mechanical ventilation during acute respiratory distress syndrome, there is no evidence that the pressure-volume curve may be useful in setting a lung-protective strategy in the presence of different potentials for recruitment.
Fifty Years of Research in ARDS. Vt Selection in Acute Respiratory Distress Syndrome
TLDR
Mechanical adjuncts such as extracorporeal carbon dioxide removal may be useful to normalize pH and carbon dioxide levels, but further studies will be necessary to demonstrate benefit with this technology.
Differences in the deflation limb of the pressure-volume curves in acute respiratory distress syndrome from pulmonary and extrapulmonary origin
TLDR
Differences between ARDSp and ARDSe PV curves are present all along the pressure axis and are related to differences not only in the Pes-V curve, but also in the Ptp-VCurve, which is only significant in the low-pressure range.
Lung and chest wall mechanics in patients with acute respiratory distress syndrome, expiratory flow limitation and airway closure.
TLDR
Higher Edyn,L was accurate to predict EFL in AR DS patients, AC can occur independently of EFL and both should be assessed concurrently in ARDS patients.
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