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Vol. 84, Issue 1, 389-395, January 1998
Departments of Anesthesia and Critical Care, and Pulmonary Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
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 + 
]
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, c
to 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 (R2) 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)/b
vs. (P c)/d,
they collapsed into a single and tight relationship (R2 = 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.
mechanical properties; lung compliance; lung recoil; acute respiratory distress syndrome; pneumoconstriction
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