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Following a recruitment maneuver prevents each alveolar collapse and recruitment/derecruitment. Am J Respir Crit Care Med 2003, 167:1620-1626.P43 Handle program for automated titration of constructive end-expiratory stress and tidal volume utilizing dynamic nonlinear compliance because the setpointS Lozano-Zahonero1, A Wahl2, D Gottlieb2, J Arntz1, S Schumann2, J Guttmann2, K M ler1 1Furtwangen University, Villingen-Schwenningen, Germany; 2University Hospital Freiburg, Germany Essential Care 2009, 13(Suppl 1):P43 (doi: ten.1186/cc7207) Introduction An automated respiratory mechanics control was created to individually adapt the power transfer from theSCritical CareMarch 2009 Vol 13 Suppl29th International Symposium on Intensive Care and Emergency Medicineventilator for the respiratory system. The controller titrates the optimistic end-expiratory stress (PEEP) and tidal volume (VT) to ventilate the lung at its maximal compliance so that you can keep away from excessive lung overinflation also as underinflation. Strategies The mechanics controller consists of a software program plan to set PEEP and VT plus a user interface to observe the compliance and also the controller state. The program has following structure: (1) Dynamic compliance is calculated breath by breath utilizing the implemented slice function . This function divides VT into six consecutive volume slices of equal size. (two) For each volume slice, one value of dynamic compliance (CSLICE) is determined by leastsquares fit making use of the linear resistance and compliance model within every Hexaminolevulinate (hydrochloride) cost single slice . The six CSLICE values are plotted over the corresponding volume, providing the compliance olume curve. (three) The shape-compliance function from the controller identifies 1 out of six shape categories . (four) The PEEP and VT-change function calculates the PEEP and VT titration depending on the shape category and sends a command towards the ventilator for setting the new PEEP and VT automatically. Final results The technique was tested with previously recorded patient data (McRem) . The compliance controller retrospectively analysed the respiratory information and determined the shape category depending on the course of CSLICE. For shapes representing an intratidal raise of CSLICE, the controller improved the PEEP. A reduction of PEEP occurred when CSLICE decreased intratidally. PEEP was maintained when CSLICE was maximal and continual. Additionally, for hybrid shape categories (1 part within the linear region and 1 portion in the growing and/or decreasing region) the VT was lowered. Conclusions The automated respiratory mechanics manage system titrates PEEP and VT automatically till intratidal compliance reaches its maximal worth inside an acceptable VT. References 1. Schumann S, et al.: Modellierung und Bestimmung der nichtlinear volumenabh gigen Compliance der Lunge. In Dreil dertagung der Deutschen, terreichischen und Schweizerischen Gesellschaften f Biomedizinische Technik, Z ich; Proceedings V118; 2006. two. Guttmann J, et al.: Determination of volume-dependent respiratory method mechanics in mechanically ventilated individuals using the new SLICE system. Technol Overall health Care 1994, 2:175-191. 3. Mols G, et al.: Volume-dependent compliance in ARDS: proposal of a brand new diagnostic notion. Intensive Care Med 1999, 25:1084-1091. four. Stahl CA, et al.: Dynamic versus static respiratory mechanics in acute lung injury and acute respiratory distress syndrome. Crit Care Med 2006, 34:2090-2098.Figure 1 (abstract P44)Solutions Functional EIT (fEIT) images were.