FIG. 4.
Representative respiratory system mechanics after pleural injury. After standardizing volume history, a recruitment maneuver was performed consisting of a 3-s ramp to a 30 cm H2O airway pressure followed by a 3-s plateau. (A) After a single 25 g needle-induced pleural injury, the recruitment maneuver demonstrated a plateau pressure of ∼15 cm H2O. After sealing the injury with the pectin-based polymer, the repeat recruitment maneuver restored the 30 cm H2O airway pressures. (B) After a through-and-through injury of the lung, the pressures similarly dropped to less than half of the 30 cm H2O plateau pressures (Injury × 2). Sealing one of the injuries with the pectin-based polymer increased plateau pressures (Seal × 1). Also sealing the second injury (Seal × 2) resulted in restoration of baseline airway pressures. Note the two phases of the pressure curve: the initial exponential decline in airway pressures followed by a quasi-plateau phase. Summary data of a single pleural injury are shown in Figure 7. Color images available online at www.liebertpub.com/tea