Pressure-Volume loops are not consistently interpreted

In case you remember my little Survey Monkey questionnaire on pressure volume loops, and were wondering about the responses, there were about 100 people who wasted a few minutes on the survey. Most were from medical professionals, (mostly neonatologists and fellows, but also residents, nurses and a few RTs) almost all were from centers that currently use ventilator graphics in managing their patients.

So I selected just those medical professionals that currently use graphics in their practice, and, as I expected, there was no consistency whatsoever in their evaluation of the curves.  For example, the last curve was considered to be needing an adjustment by 85% of the respondents, 56% thought it was over-distended, and needed some sort of reduction in ventilation assistance, 28% thought it was under-inflated and needed an increase in ventilation assistance. Here is the loop:

20140130_104323

And here are the answers:

Choix de réponses
Réponses
It shows over-distension and I would reduce the set volume
40,48%
It shows over-distension and I would reduce the PEEP
16,67%
The loop is perfect, I would make no changes
14,29%
It shows under-inflation and I would increase the set volume
9,52%
It shows under-inflation and I would increase the PEEP
19,05%

I looked at those responses from people who did not use graphics, and they were about the same.

Makes you think…

About keithbarrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal
This entry was posted in Neonatal Research. Bookmark the permalink.

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