CT-SCAN EVIDENCE OF HYPERINFLATION DURING NIH PROTECTIVESTRATEGY VENTILATION IN ARDS PATIENTS

INTRODUCTION. NIH mechanical ventilation protocol is the standard of care in ARDS. However individual characteristics of respiratory mechanics may expose the lung to some degree of mechanical stress. In the present study we tested the hypotesis that combination of morphological (CT scan) and functional (static PV curve) analysis may identify patients at risk of mechanical stress. METHODS. 22 ARDS patients (NIH protective ventilatory strategy) were enrolled. Static P/V curve at zeep where obtained before CT. CT slides were achieved during end-inspiration and end–expiration hold and analyzed to detect total lung volume distribution. RESULTS. In 10 patients the tidal increase in lung volume occurred with a 30-50 % increase of hyperinflated areas. In these patients Pplat during the NIH ventilation was higher than the UIP CONCLUSION. Combined evaluation of lung morphology on respiratory mechanics identify risk of mechanical stress in ARDS patients.