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Diagnosis of causes for acute respiratory distress by pressure-volume curves.

The determination of effective dynamic and static relationships between pressure and volume aided in the diagnosis of pulmonary disease, its course, and the effects of therapy in 22 patients receiving continuous mechanical ventilation. These measurements were made on multiple occasions early in the course of mechanical ventilation and were repeated after any indication of clinical deterioration. Abrupt changes from control measurements provided supportive evidence for the presence of cardiogenic pulmonary edema in four patients, progressive pneumonia in four patients, bronchoconstriction in four patients, retained secretions in five patients, pneumothorax in two patients, intubation of main-stem bronchus in three patients, and atelectasis in two patients and were useful in evaluating the results of subsequent therapy. These determinations are simple, noninvasive, and can be accomplished within minutes. The equipment needed is the same as that needed for continuous mechanical ventilation.