Etween the location on the P curves as well as the product of maximal volume by maximal pressure. Even taking into consideration thermodynamics and gas exchange correction, Vgas values have been systematically higher than Vcw in all probability due to blood shifts in the thorax to the extremities. As a consequence, the normal supersyringe system gives 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 ?5.9* 15.two ?five.The data 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.four 3.8 17.Conclusion: Despite restricted quantity of sufferers and possible influence of utilized gear on crucial worth of ELR we found that combined assessment of compliance and recruited lung volume enables superior 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 does not boost 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 could be the cornerstone of remedy of individuals with ALI and ARDS, however it just isn’t free of adverse effects. This study aims to examine the impact of varying levels of PEEP on the intraocular stress in critically ill sufferers with intracranial pathology. Components and approaches: We studied 40 patients with intracranial pathology and respiratory failure, devoid of history of glaucoma and not receiving drugs identified to influence intraocular stress. Twentyone patients had head injury (GCS eight on admission), 11 had buy BFH772 subarachnoid hemorrhage (III-IV Hunt and Hess) and eight had intracerebral hemorrhage. Measurement of intraocular pressures exactly where done when the sufferers had been mechanically ventilated with various levels of PEEP. These sufferers were divided in four groups (A, B, C, D) of ten individuals. Each and every group had distinct PEEP values in accordance with the attending physician for no less than > 24 hours (see Table). Imply systemic arterial stress, peak airway pressure, central venous PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20718733 stress and arterial oxygen saturation had been recorded (see Table).We hypothesized that resulting from collapse tendency 1) the effect of a lung recruitment maneuver (LR) on a pressure bsolute lung volume (P ) curve would be minimal, two) but if LR is followed quickly.