[Pathophysiology of recruit ventilation and its effect on the respiration biomechanics (review of the literature)].

In patients with acute respiratory distress syndrome (ARDS) lungs consist of aeration zones and zones of alveolar collapse, which lead to intrapulmonary shunting and hypoxemia. ALV may increase alveolar collaps and potentially lead to lung damage arising out of displacing surfaces tension between aerated and collapsed lung parts and re-closing and opening of the alveoli. Based on the strategy of the "open lung" the recruitment maneuver can be used to achieve the alveolar recruitment, while PEEP prevents alveolar collapse.

[Choice of the parameters of artificial ventilation in patients with acute respiratory distress syndrome].

The paper presents the results of use of two modes of controlled artificial ventilation (ALV) in adult patients with acute respiratory distress syndrome of various genesis: 1) ALV with its controlled volume, the descending pattern of inspiratory flow, the limitation of respiratory volume in the airways (RV, 6-8 ml/kg; Ptr.peak < 30 cm H2O), 2) ALV with its controlled volume, the orthogonal pattern of inspiratory flow (RV, 12-15 ml/kg, Ptr.peak > 35 cm H2O).

[Criteria for adequate respiratory support during transfer of patients to spontaneous respiration].

Time course of circulation, oxygen transport and consumption parameters were studied in patients with parenchymatous pulmonary diseases during their transfer to spontaneous respiration under conditions of pressure support ventilation after long forced ventilation of the lungs. The oxygen cost of respiration can serve as a reliable criterion of respiratory support adequacy when the use of a respirator is discontinued. With oxygen cost of respiration at least 14%, a decrease of respiratory support is hardly possible without decompensation of the respiration system and circulation, which dictates monitoring of this parameter during transfer of patients to spontaneous respiration.

[Occlusion pressure in the first 100 ms of inspiration (P0.1) as an index of the possibility of decreasing respiratory support in acute respiratory failure].

The need in making the process of transfer of patients to spontaneous respiration using ventilation of the lungs with inspiratory pressure support (VLIPS) after prolonged mechanical ventilation of the lungs prompted the authors to analyze the prognostic value of criteria traditionally used by the physician to cease or decrease the respiratory support (vital capacity of the lungs, peak spontaneous flow, PaO2, etc.) and the P0.1 occlusion pressure in the airways at the end of the first 100 msec of inhalation.