Agreement Between Peak Inspiratory Pressure in Decelerating-Flow Ventilation and Plateau Pressure in Square-Flow Ventilation in Pediatric Acute Respiratory Distress Syndrome*

OBJECTIVES: Acute respiratory distress syndrome guidelines suggest limiting plateau pressures to 28–30 cm H2O. Plateau pressure is most accurately measured in square-flow modes, such as volume control. In children, decelerating-flow modes, such as pressure-regulated volume control and pressure control, are more common. Consequently, plateau pressures are rarely obtained, and pressure limits are instead provided for peak inspiratory pressure. The degree to which peak inspiratory pressure in decelerating-flow overestimates plateau pressure is unknown. Therefore, we assessed the correlation and accuracy of peak inspiratory pressure in decelerating-flow ventilation for approximating plateau pressure during square-flow ventilation. DESIGN: Prospective, observational study. SETTING: Tertiary, academic PICU. PATIENTS: Fifty-two intubated children with acute respiratory distress syndrome enrolled between January 2020 and May 2021. INTERVENTIONS: Measurement of peak inspiratory pressure in decelerating-flow ventilation and plateau pressure after transition to square-flow ventilation. MEASUREMENTS AND MAIN RESULTS: Peak inspiratory pressure in decelerating-flow was highly correlated (r2 = 0.99; p
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Brief Report Source Type: research