Figure 3.

Example of changes in airway, transpulmonary and pulmonary arterial pressure in response to lung recruitment. This example presents the simultaneous recording of airway, transpulmonary and pulmonary arterial pressures in a patient during cardiac surgery in which two consecutive maneuvers were performed. Clear systolic and pulse PA pressure changes occur after each maneuver. The circles highlight the condition reached after recruitment when final protective ventilator settings were adjusted with a PEEP level of 10 and a reduced driving pressure which corresponds to a reduced transpulmonary driving pressure and pulmonary artery pulse pressure. Also note that expiratory transpulmonary pressure remains positive after the first recruitment suggesting an open lung condition. In the lower panel selected individual PA waveforms from different moments of the sequence are presented. Note the different morphology and amplitude. PEEP, positive end-expiratory pressure; PA, pulmonary arterial.