Dynamic elastic pressure-volume loops in healthy pigs recorded with inspiratory and expiratory sinusoidal flow modulationRelationship to static pressure-volume loops.

Objective: The objective was to analyse relationships between inspiratory and expiratory static and dynamic elastic pressure-volume (P-el/V) curves in healthy pigs. Design: The modulated low flow method was developed to allow studies also of the expiratory P-el/V curves. Static P-el/V (P-el,P-st/V) and dynamic P-el/V (P-el,P-dyn/V) loops were studied in healthy pigs. Setting: Animal research laboratory in a university hospital. Material: Ten healthy anaesthetised and paralysed pigs. Interventions and measurements: A computer controlled a Servo Ventilator 900C with respect to respiratory rate, inspiratory flow and expiratory pressure to achieve a sinusoidal modulation of inspiration and expiration for determination of P-el,P-dyn/V loops from zero end-expiratory pressure (ZEEP) and from a positive end-expiratory pressure (PEEP) of 6 cmH(2)O to 20, 35 and 50 cmH(2)O. The same system was used for studies of P-el,P-st/V loops with the flow-interruption method from ZEEP and PEEP to 35 cmH(2)O. Recordings were analysed with an iterative technique. Results: The feasibility of automated determination of P-el,P-dyn/V loops was demonstrated. Differences between P-el,P-dyn/V and P-el,P-st/V loops were explained by viscoelastic behaviour. P-el,P-st/V loops recorded from PEEP to 35 cmH(2)O showed no significant hysteresis, indicating a non-significant surface tension hysteresis. P-el,P-dyn/V loops from PEEP and both P-el,P-st/V and P-el,P-dyn/V loops from ZEEP to 35 cmH(2)O showed hysteresis. This indicates that lung collapse/re-expansion caused P-el/V loop hysteresis which, in P-el,P-dyn/V loops, was augmented by viscoelastic behaviour. Conclusions: Viscoelasticity influences P-el,P-dyn/V curves. Hysteresis caused by surface tension merits re-evaluation. Lung collapse and re-expansion may be indicated by hysteresis of P-el/V loops.