Mesure de la capacité résiduelle fonctionnelle chez le patient ventilé : mesures, déterminants, implications cliniques, perspectives

Reduction of end expiratory lung volume during the acute respiratory distress syndrome (ARDS) has been well documented with CT scan and gas dilution techniques (helium). Two washin/washout techniques (oxygen and nitrogen) have recently been improved allowing simplified bedside end expiratory lung volume measurements. Lung volume loss is variable during ARDS. Several factors are associated with lung volume decrease during mechanical ventilation like supine position, pulmonary disease, abdominal pressure or heart weight. Integrating lung volume measure in our monitoring tools may have two interests: first helping to distinguish recruitment and overdistension and better adjustment of delivered volumes; second helping the clinician to diagnose patients responders to different therapeutic strategies like positioning, recruitment manoeuvre or PEEP setting.