A 65-year-old man on ICU has ARDS. His plateau pressure is 28 cmH2O, PEEP 12, TV 380 mL. The team calculates static compliance as 380/(28-12) = 23.75 ...

Question

A 65-year-old man on ICU has ARDS. His plateau pressure is 28 cmH2O, PEEP 12, TV 380 mL. The team calculates static compliance as 380/(28-12) = 23.75 mL/cmH2O. They want to know the chest wall compliance to distinguish lung from chest wall contributions. Without oesophageal manometry, what clinical factors suggest reduced chest wall compliance as a significant contributor?

Accepted Answer

Obesity (BMI >35), abdominal distension/ascites, circumferential chest wall burns, flail chest, and prone positioning - all reduce chest wall compliance, increasing plateau pressure without worsening lung disease; oesophageal manometry is needed for precise measurement

Answer

There are no clinical predictors

Answer

Only age affects chest wall compliance

Answer

Chest wall compliance never contributes to plateau pressure

Answer

CT is the only way to assess chest wall compliance

uk-fficm MCQ (SBA): Chest Wall Compliance