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# Principles of Mechanical Ventilation ## Table 1-3 Clinical Conditions That Decrease the Compliance | Type of Compliance | Clinical Conditions | |---|---| | Static compliance | ARDS, Atelectasis, Tension pneumothorax, Obesity, Retained secretions, Bronchospasm, Kinking of ET tube, Airway obstruct...

# Principles of Mechanical Ventilation ## Table 1-3 Clinical Conditions That Decrease the Compliance | Type of Compliance | Clinical Conditions | |---|---| | Static compliance | ARDS, Atelectasis, Tension pneumothorax, Obesity, Retained secretions, Bronchospasm, Kinking of ET tube, Airway obstruction | | Dynamic compliance | (no list provided) | **Low Compliance:** Measurements are usually related to conditions that reduce the patient's functional residual capacity. Patients with noncompliant lungs often have a restrictive lung defect, low lung volumes, and low minute ventilation. This condition may be compensated for by an increased frequency. **High Compliance:** High compliance means that the volume change is large per unit pressure change. In extreme high compliance situations, exhalation is often incomplete due to the lack of elastic recoil by the lungs. Emphysema is an example of high compliance where the gas exchange process is impaired. This condition is due to chronic air trapping, destruction of lung tissues, and enlargement of terminal and respiratory bronchioles. High compliance measurements are usually related to conditions that increase the patient's functional residual capacity and total lung capacity. Patients with extremely compliant lungs often develop airflow obstruction, incomplete exhalation, air trapping, and poor gas exchange. **Static and Dynamic Compliance:** Assessment of compliance can be divided into static and dynamic compliance measurements. **Static Compliance:** Static compliance is calculated by dividing the volume by the pressure (i.e., plateau pressure) measured when the flow is momentarily stopped. When airflow is absent, airway resistance becomes a non-factor. Static compliance reflects the elastic resistance of the lung and chest wall. **Dynamic Compliance:** Dynamic compliance is calculated by dividing the volume by the pressure (i.e., peak inspiratory pressure) measured when airflow is present. Since airflow is present, airway resistance becomes a factor in the measurement of dynamic compliance. Dynamic compliance therefore reflects the condition of airway. **Treatment:** - PEEP - FiO2 - Position **Patient:** Patient with low lobe pneumonia, end-of-cup hypoxemia, pt with 40 min **Lung Compliance:** - Low lung compliance = increased work of breathing. - In extreme high compliance situations, exhalation is often incomplete due to reduced elastic recoil of the lungs. - Static compliance reflects the elastic properties (elastic resistance) of the lung and chest wall. - Dynamic compliance reflects the airway resistance (nonelastic resistance) and the elastic properties of the lung and chest wall (elastic resistance).