Peak inspiratory pressure lacks accuracy to estimate plateau pressure in infants with severe obstructive lower airway disease.

Purpose: In children with acute respiratory distress syndrome receiving mechanical ventilation, the peak inspiratory pressure (PIP) is close to plateau pressure (P) when inspiratory flow approaches zero. We aimed to evaluate the reliability of PIP to estimate P in infants with severe respiratory viral infection (SRVI), characterized by increased airway resistance, and the accuracy of an equational model to estimates P (eP) based on PIP.

Methods: This was a retrospective observational study including mechanically ventilated children (1 to 24 month old) with SRVI, whose respiratory mechanics measurements were performed to evaluate PIP and P The measured P was compared with the result of the equation: eP = PIP - [5.