What is the significance of monitoring plateau pressure in mechanically ventilated patients?

Monitoring plateau pressure in mechanically ventilated patients is crucial because it provides important insights into the risk of ventilator-induced lung injury. Plateau pressure is defined as the pressure measured during an inspiratory pause when there is no airflow, reflecting the pressure in the alveoli of the lungs. When the plateau pressure is elevated, it can indicate increased lung compliance or decreased lung volume, which suggests that the lung tissue may be subject to excessive stretching.

An increase in plateau pressure is associated with higher risk factors for lung injury, such as overdistension of alveoli, especially in patients with conditions like acute respiratory distress syndrome (ARDS). Keeping plateau pressure within safe limits (generally <30 cmH2O) helps minimize the risk of damage to the alveolar-capillary interface and preserves lung function. Thus, monitoring plateau pressure enables clinicians to make informed adjustments in ventilation strategies to protect the lung from injury while optimizing oxygenation and ventilation.