Tidal Volume Reduction in ARDS James W Leatherman, M.D., F.C.C.P., Richard L. Lari, M.D., Conrad Iber, M.D., F.C.C.P., Arthur L. Ney, M.D.  CHEST  Volume 99, Issue 5, Pages 1227-1231 (May 1991) DOI: 10.1378/chest.99.5.1227 Copyright © 1991 The American College of Chest Physicians Terms and Conditions

FIGURE 1 Change in cardiac output (ΔQ percent) and change in PaO2 (Δ PaO2) following 200 ml VT reduction at 15 cm H2O of PEEP. CHEST 1991 99, 1227-1231DOI: (10.1378/chest.99.5.1227) Copyright © 1991 The American College of Chest Physicians Terms and Conditions

FIGURE 2 Change in cardiac output (Δ Q percent) vs change in static compliance (ΔCst) after 200 ml VT reduction at 15 cm H2O of PEEP CHEST 1991 99, 1227-1231DOI: (10.1378/chest.99.5.1227) Copyright © 1991 The American College of Chest Physicians Terms and Conditions

FIGURE 3 Hypothetical P-V curve with varying VT and PEEP At 0 PEEP and HiVT, ventilation occurs on the ascending limb of the P-V curve (α1→A2). After FRC has been increased with PEEP, the same HiVT causes ventilation to occur beyond the inflection point, on the flatter part of the P-V curve (B1→B2). Reduction in VT at HiPEEP results in ventilation to once again occur on the ascending limb (B1→A2). CHEST 1991 99, 1227-1231DOI: (10.1378/chest.99.5.1227) Copyright © 1991 The American College of Chest Physicians Terms and Conditions