Hi community, how are you? My colleagues and I have been debating this question and we would like you to give your opinion. I'll give you an explanation and context.

Context: Patient fully sedated, no respiratory drive, with highly inhomogeneous lungs ventilated in PC mode. In the inspiratory phase, you have a zero flow section at end-inspiration concluding that your preset Ti is longer than the RCinsp of the patient.

In that case, you would say that preset pressure (PC + PEEP) is equal to alveolar pressure because the gradient is no longer letting air flow into the patient.

Question: Would it be the same to say that alveolar pressure is equal to peak pressure when you analyze it in dynamic conditions instead of assessing it in static conditions with an end-inspiration pause?

Hypothesis: In static conditions, with an inspiratory pause, I would say that the pendelluft effect would be more present in these heterogeneous lungs with collateral ventilation. Otherwise, in dynamic situations, with PC applied to the lungs with no flow, it could be more ventilation in the units with less resistance generating overdistension.

Thanks very much, it may seem tricky but I think that for some of you the answer is a lot easier. You could contact me with your response or at my personal email: [email protected].