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Fig. 4 | Annals of Intensive Care

Fig. 4

From: Prevention and treatment of acute lung injury with time-controlled adaptive ventilation: physiologically informed modification of airway pressure release ventilation

Fig. 4

The ARDSnet method using the volume assist-control ventilation mode (left) has an I:E ratio of 1:3, which directs a short inspiration and a long expiration, and PEEP is arbitrarily set. Conversely, the TCAV method (right) has an I:E ratio of 12:1, which directs a long inspiration (CPAP phase) and a short expiration (release phase), not allowing the lung to fully depressurize and resulting in a time-controlled PEEP (TC-PEEP, red dashed line). Time controlled-PEEP (TC-PEEP) is adaptive (not arbitrary) because it is determined in real-time according to compliance, which is measured in the preceding breath by the slope of the expiratory flow curve (SlopeFE) (red arrowhead on right) (Fig. 6)

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