A comprehensive equation for the pulmonary pressure-volume curve

Author:

Venegas José G.1,Harris R. Scott1,Simon Brett A.1

Affiliation:

1. Departments of Anesthesia and Critical Care, and Pulmonary Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114

Abstract

Venegas, José G., R. Scott Harris, and Brett A. Simon.A comprehensive equation for the pulmonary pressure-volume curve. J. Appl. Physiol. 84(1): 389–395, 1998.—Quantification of pulmonary pressure-volume (P-V) curves is often limited to calculation of specific compliance at a given pressure or the recoil pressure (P) at a given volume (V). These parameters can be substantially different depending on the arbitrary pressure or volume used in the comparison and may lead to erroneous conclusions. We evaluated a sigmoidal equation of the form, V = a + b[1 +[Formula: see text]]−1, for its ability to characterize lung and respiratory system P-V curves obtained under a variety of conditions including normal and hypocapnic pneumoconstricted dog lungs ( n = 9), oleic acid-induced acute respiratory distress syndrome ( n = 2), and mechanically ventilated patients with acute respiratory distress syndrome ( n = 10). In this equation, a corresponds to the V of a lower asymptote, b to the V difference between upper and lower asymptotes, cto the P at the true inflection point of the curve, and d to a width parameter proportional to the P range within which most of the V change occurs. The equation fitted equally well inflation and deflation limbs of P-V curves with a mean goodness-of-fit coefficient ( R 2) of 0.997 ± 0.02 (SD). When the data from all analyzed P-V curves were normalized by the best-fit parameters and plotted as (V − a)/ bvs. (P − c)/ d, they collapsed into a single and tight relationship ( R 2 = 0.997). These results demonstrate that this sigmoidal equation can fit with excellent precision inflation and deflation P-V curves of normal lungs and of lungs with alveolar derecruitment and/or a region of gas trapping while yielding robust and physiologically useful parameters.

Publisher

American Physiological Society

Subject

Physiology (medical),Physiology

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