[Significance of static pressure-volume loop for differential diagnostics and optimization of respiratory support in parenchimal respiratory failure].

PURPOSE OF THE STUDY: To determine significance of static pressure-volume loop (PV loop) for differential diagnostics of parenchymal respiratory failure, setting of positive end-expiratory pressure (PEEP) and recruit ability of the lung. MATERIALS AND METHODS: 76 patients (52 males) with parenchymal respiratory failure were included in the study (oxygenation index (PaO2/ FiO2) 0.05). Empirically set PEEP (by maximum PaO2/FiO2) was much higher than LIP (p 0.05), but predicts PEEP-induced alveolar recruitment during static PV loop plotting (rho = 0.493, p 0.05). After static PV loop plotting combined with sustained inflation maneuver recruited volume of the lungs was 350 (250-450) ml. We didn't find significant differences between recruit ability of the diffuse and locally injured lungs (p > 0.05). Recruitment volume has no correlations with all points and segments of static PV loop. CONCLUSIONS: Static PV loop has limited prognostic value for differential diagnostics of diffuse or local lung injury and brings potential harm for setting PEEP according to LIP. LIP more than 10 mbar can predict diffuse lung injury. Clin can predict volume of PEEP-induced recruitment. In diffuse lung injury LIP correlates with empirically set PEEP.