Related Experiment Video

Updated: Mar 15, 2026

Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics
12:09

Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics

Published on: April 19, 2024

2.3K

Intratidal recruitment/derecruitment persists at low and moderate positive end-expiratory pressure in paediatric

Steffen Wirth1, Lisa Artner1, Tobias Broß1

  • 1Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg, Germany.

Respiratory Physiology & Neurobiology
|September 3, 2016
PubMed

Insights

In pediatric patients, higher positive end-expiratory pressure (PEEP) improved respiratory mechanics and ventilation distribution. While not fully preventing lung recruitment/derecruitment, a PEEP of 5cmH2O homogenized ventilation compared to 2cmH2O.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Physiology
  • Mechanical Ventilation

Background:

  • Positive end-expiratory pressure (PEEP) is typically lower in pediatric patients than adults.
  • The impact of moderately higher PEEP on respiratory mechanics and regional ventilation in children is not fully understood.

Purpose of the Study:

  • To investigate if a moderately higher PEEP level improves respiratory mechanics and regional ventilation in mechanically ventilated pediatric patients.
  • To assess the occurrence and severity of intratidal recruitment/derecruitment at different PEEP levels in children.

Main Methods:

  • 40 pediatric patients undergoing mechanical ventilation were studied.
  • Two PEEP levels (2 and 5 cmH2O) were applied.
  • Respiratory mechanics were evaluated using volume-dependent compliance profiles.
  • Regional ventilation was assessed using electrical impedance tomography (EIT).

Main Results:

  • Mean compliance increased significantly from 17.9±9.9 mL/cmH2O at PEEP 2 to 19.0±10.9 mL/cmH2O at PEEP 5 (p<0.001).
  • Intratidal recruitment/derecruitment was observed in 40% of patients at PEEP 2 and 36% at PEEP 5.
  • Younger children exhibited more prominent intratidal recruitment/derecruitment.
  • Higher PEEP improved peripheral ventilation distribution.

Conclusions:

  • Mechanically ventilated pediatric patients experience intratidal recruitment/derecruitment, particularly younger children.
  • A PEEP of 5 cmH2O, while not eliminating intratidal recruitment/derecruitment, led to more homogeneous regional ventilation compared to 2 cmH2O.
  • Moderately higher PEEP may benefit respiratory mechanics and ventilation distribution in pediatric patients.

Keywords:
ChildrenCompliance–volume curveFunctional residual capacityLung complianceMechanical ventilationProtective ventilationRespiratory system mechanics

More Related Videos

Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit05:56

Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit

Published on: September 6, 2024

6.9K
Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS06:22

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS

Published on: April 7, 2021

3.9K

Related Concept Videos

Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
4.5K
Mechanical Ventilation II: Invasive Ventilation01:23

Mechanical Ventilation II: Invasive Ventilation

Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
947
Mechanical Ventilation III: Noninvasive Ventilation01:23

Mechanical Ventilation III: Noninvasive Ventilation

Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
757
Mechanical Ventilation I: Indication and Settings01:29

Mechanical Ventilation I: Indication and Settings

Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
3.4K
Pulmonary Ventilation: Inhalation01:24

Pulmonary Ventilation: Inhalation

Pulmonary ventilation is a vital process that ensures the exchange of oxygen and carbon dioxide in the lungs. It refers to the movement of air into and out of the lungs, enabling the body to obtain oxygen and remove waste carbon dioxide. In this article, we will explore the intricacies of pulmonary ventilation, including its underlying principles, mechanisms, and the interplay of pressures within the respiratory system.
Boyle's law becomes particularly pertinent when examining respiratory...
9.5K
Ventilatory Modes01:14

Ventilatory Modes

Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
1.9K