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Just after a recruitment maneuver prevents both alveolar collapse and recruitment/derecruitment. Am J Respir Crit Care Med 2003, 167:1620-1626.P43 Manage technique for automated titration of constructive end-expiratory pressure and tidal volume using dynamic nonlinear compliance as the setpointS Lozano-Zahonero1, A Wahl2, D Gottlieb2, J Arntz1, S Schumann2, J Guttmann2, K M ler1 1Furtwangen University, Villingen-Schwenningen, Germany; 2University Hospital Freiburg, Germany Important Care 2009, 13(Suppl 1):P43 (doi: 10.1186/cc7207) Introduction An automated respiratory mechanics handle was created to individually adapt the power transfer from theSCritical CareMarch 2009 Vol 13 Suppl29th International Symposium on Intensive Care and Emergency Medicineventilator to the respiratory technique. The controller titrates the good end-expiratory pressure (PEEP) and tidal volume (VT) to ventilate the lung at its maximal compliance so that you can steer clear of excessive lung overinflation also as underinflation. Methods The mechanics controller consists of a software system to set PEEP and VT in addition to a user interface to observe the compliance and also the controller state. The plan has following structure: (1) Dynamic compliance is calculated breath by breath working with the implemented slice function . This function divides VT into six consecutive volume slices of equal size. (2) For each and every volume slice, 1 worth of dynamic compliance (CSLICE) is determined by leastsquares fit making use of the linear resistance and compliance model N and function in experimental acute lung injuryM Gama de Abreu within each slice . The six CSLICE values are plotted more than the corresponding volume, giving the compliance olume curve. (3) The shape-compliance function with the controller identifies 1 out of six shape categories . (four) The PEEP and VT-change function calculates the PEEP and VT titration according to the shape category and sends a command towards the ventilator for setting the new PEEP and VT automatically. Benefits The system was tested with previously recorded patient data (McRem) . The compliance controller retrospectively analysed the respiratory information and determined the shape category based on the course of CSLICE. For shapes representing an intratidal raise of CSLICE, the controller elevated the PEEP. A reduction of PEEP occurred when CSLICE decreased intratidally. PEEP was maintained when CSLICE was maximal and continual. Moreover, for hybrid shape categories (one particular element within the linear area and one aspect within the growing and/or decreasing region) the VT was decreased. Conclusions The automated respiratory mechanics manage system titrates PEEP and VT automatically until intratidal compliance reaches its maximal value inside an suitable VT. References 1. Schumann S, et al.: Modellierung und Bestimmung der nichtlinear volumenabh gigen Compliance der Lunge. In Dreil dertagung der Deutschen, terreichischen und Schweizerischen Gesellschaften f Biomedizinische Technik, Z ich; Proceedings V118; 2006. two. Guttmann J, et al.: Determination of volume-dependent respiratory method mechanics in mechanically ventilated individuals making use of the new SLICE technique. Technol Wellness Care 1994, 2:175-191. three. Mols G, et al.: Volume-dependent compliance in ARDS: proposal of a brand new diagnostic idea. Intensive Care Med 1999, 25:1084-1091. 4. Stahl CA, et al.: Dynamic versus static respiratory mechanics in acute lung injury and acute respiratory distress syndrome. Crit Care Med 2006, 34:2090-2098.Figure 1 (abstract P44)Approaches Functional EIT (fEIT) pictures were.