barotrauma and Pplat

Q: At what level of plateau pressure (Pplat)the chances of barotrauma goes exponentially high while on mechanical ventilator? (select one)

A) Pplat >30 cm H2O 
B) Pplat >35 cm H2O


Answer:  B

The plateau pressure during mechanical ventilation is an excellent representation of pressure applied to the small airways and alveoli. Although barotrauma can occur anytime while on ventilator but risk goes exponentially high with a Pplat >35 cm H2O. Data shows very strong relationship between barotrauma and a Pplat >35 cm H2O. To obtain Pplat, a provider needs to apply a hold on inspiratory breath for 1-2 seconds on the ventilator.

#ventilators
#pulmonary


References:

1. Boussarsar M, Thierry G, Jaber S, et al. Relationship between ventilatory settings and barotrauma in the acute respiratory distress syndrome. Intensive Care Med 2002; 28:406.


2. International consensus conferences in intensive care medicine: Ventilator-associated Lung Injury in ARDS. This official conference report was cosponsored by the American Thoracic Society, The European Society of Intensive Care Medicine, and The Societé de Réanimation de Langue Française, and was approved by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med 1999; 160:2118.