The determination of the maximum pressure achieved during the inspiratory phase of mechanical ventilation is a crucial aspect of respiratory management. This measurement, typically expressed in centimeters of water (cmH2O), reflects the highest pressure exerted on the airways and alveoli during each breath delivered by the ventilator. It is influenced by factors such as tidal volume, inspiratory flow rate, airway resistance, and lung compliance. For example, a higher tidal volume delivered with a rapid flow rate, in the presence of increased airway resistance (e.g., bronchospasm), will result in an elevated value.
Accurate assessment and management of this pressure are essential to minimize the risks of ventilator-induced lung injury (VILI). Elevated values can lead to barotrauma, including pneumothorax and pneumomediastinum, while excessively low values may indicate inadequate ventilation. Historically, reliance on clinical observation alone was inadequate for optimizing ventilator settings. The integration of this quantitative measure into clinical practice allows for individualized ventilation strategies aimed at protecting the patient’s lungs while ensuring adequate gas exchange. This approach has been shown to improve patient outcomes and reduce the duration of mechanical ventilation.
