Schematic of mechanisms behind the better recruitment of alveoli with spontaneous breathing. Schematic of mechanisms behind the better recruitment of alveoli.

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Presentation transcript:

Schematic of mechanisms behind the better recruitment of alveoli with spontaneous breathing. Schematic of mechanisms behind the better recruitment of alveoli with spontaneous breathing. The left panels show the excursion of the diaphragm during mechanical ventilation and spontaneous breathing. Note the greater excursion in dorsal parts with spontaneous breathing. The right panels show the difference in the vertical pressure gradient during mechanical ventilation and spontaneous breathing, with a larger variation with mechanical ventilation and the potential of developing positive pleural pressure in the lower parts. This will promote collapse of alveoli. From Reference 46, with permission. Exp = expiratory; insp = inspiratory. Robert M Kacmarek, and Richard D Branson Respir Care 2016;61:854-866 (c) 2012 by Daedalus Enterprises, Inc.