plateaudruk

Plateaudruk, in medical contexts often referred to as plateau pressure, is a respiratory parameter used primarily during mechanical ventilation and anesthesia. It represents the pressure in the alveoli at the end of inspiration when airflow is momentarily halted, so there is no resistive pressure from the airways.

Measurement and interpretation: Plateaudruk is measured during an inspiratory hold or pause (typically about 0.5 to 1 second) when there is no gas flow. The pressure recorded during this pause reflects the distending pressure acting on the lungs and chest wall, i.e., the compliance of the respiratory system. A higher plateau pressure indicates reduced compliance or increased intra-thoracic pressure, and it is associated with a greater risk of ventilator-induced lung injury.

Clinical use: Plateaudruk is used to guide ventilator settings, especially tidal volume and PEEP. Clinicians aim to keep plateau pressure below about 30 cm H2O in adults to minimize the risk of volutrauma and barotrauma. If plateau pressure is elevated, options include lowering tidal volume, optimizing PEEP, or addressing factors that reduce lung compliance such as edema or fibrosis.

Relation to other pressures: Peak inspiratory pressure includes both plateau pressure and pressures needed to overcome airway resistance. The difference between peak inspiratory pressure and plateau pressure reflects airway resistance, while plateau pressure alone reflects the distending pressure of the lungs.

Limitations: The measurement requires a stable patient condition and a proper inspiratory pause; factors such as active leaks or patient-ventilator asynchrony can affect accuracy. Plateaudruk is a key indicator of lung mechanics but must be interpreted within the broader clinical context.