杂志名称：AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE

IF(2022-2024年）：24.7

发表时间：2019 Dec.

Abstract

A 13-month old, 10.5kg infant with Pediatric ARDS secondary to pneumonia underwent a positive end-expiratory pressure (PEEP) decrease monitored with electrical impedance tomography. Under assist-control ventilation, PEEP was lowered from 13 to 5cmH2O, 2cmH2O every 3 min, maintaining 10cmH2O of driving pressure. From PEEP 9cmH2O, EIT showed progressive lung collapse. At PEEP 5cmH2O respiratory instability was evident . Pendelluft was recognized, a phenomenon characterized by the movement of air between different lung regions. Typically, dependent lung regions inflate first causing deflation of non-dependent areas at the start of inspiration. 

Pendelluft, here described for the first time in an infant, is a potentially harmful phenomenon that emerges in the context of lung injury and increased inspiratory efforts. The negative swings in pleural pressures concentrate close to the dependent lung zones, indicating that pleural pressures are not evenly transmitted through collapsed lungs (solid-like behavior). 

https://pubmed.ncbi.nlm.nih.gov/31260637/#full-view-affiliation-1