What question did this study set out to answer?

The aim is to determine the association between elevated pleural pressures and airway collapse during mechanical ventilation.

May 20, 2026

A55-16 The Association of Elevated Pleural Pressures, Airway Opening Pressure and Expiratory Flow Limitation

Key Points

The aim is to determine the association between elevated pleural pressures and airway collapse during mechanical ventilation.
Included mechanically ventilated patients with hypoxemic respiratory failure.
Measured slow-flow pressure-volume curves with varying PEEP levels.
Identified airway opening pressure and expiratory flow limitation through visual inspection and the Rex method.
AOP occurred in 12 patients and EFL in 9 patients, with a significant association (p = 0.028).
In patients with AOP, airway opening occurred at a median pressure of 5.9 cmH2O.
Mean expiratory resistance was significantly higher in the EFL group at 55.02 cmH2O/L/s compared to 12.43 cmH2O/L/s (p < 0.001).

Abstract

Abstract Background 0.001. Among the 9 patients with EFL, 4 (44.4%) had complete resolution, 3 (33.3%) had partial resolution and 2 (22.2%) had no resolution of the EFL at 80% of auto-PEEP. Among the 8 patients with both AOP and EFL, when the PEEP was set at AOP, 4 (50.0%) patients had complete resolution and 2 (28.6%) had partial resolution of the EFL. Results available in Table 1. Conclusions Elevated pleural pressure is a potential etiology for EFL and AOP. Measuring EFL, AOP and the pressures set on the ventilator to overcome inspiratory and expiratory collapse could help improve ventilator support in critically ill patients. Further studies are needed to comprehensively understand these phenomena and their clinical implications This abstract is funded by: None

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A55-16 The Association of Elevated Pleural Pressures, Airway Opening Pressure and Expiratory Flow Limitation

Key Points

Abstract

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