Riods of respiration and respiratory cycles for analysis selected based on predefined selection rules. Mechanical ventilator settings were the same before and after recruitment. The total areas were measured by using the Image-J program (Table 1). Arterial blood gases were obtained immediately before and after recruitment and in close proximity (within 1 min) of VRI (Table 2). Statistical analysis was performed using a t test. Figures 1 and 2 show representative images before and after recruitment and PEEP elevation. Discussion This case demonstrates a significant increase in the geographical area of vibration response images at peak inspiration after recruitment maneuver and a PEEP increase in early ARDS. This increase in VRI area correlates with improvement in oxygenation. Conclusion Increased spatial distribution of ventilation following effective recruitment has previously been demonstrated using computerized tomography. VRI may provide a rapid bedsideTable 1 (abstract P15) Mean area (pixels) Pre-recruitment (n = 5 breaths) 47,863.8 Standard deviation 3557.7 2735.After-recruitment (n = 5 breaths) 60,888.2 *(<0.0025)Table 2 (abstract P15) FiO2 Pre-recruitment After recruitment 1.0 1.0 pH 7.29 7.22 pO2 76 143 pCO2 23SCritical CareMarch 2006 Vol 10 Suppl26th International Symposium on Intensive Care and Emergency MedicineFigure 1 (abstract P15)Methods Airway pressure (Pao), flow (V) and volume (V) were recorded from 11 ARDS PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/2805811 patients under MV at 10 and 20 c/min. Data were analyzed according to: Pao = EEP + Ers.V + Rrs.V and Pao = EEP + Ers.V + Rrs.V + Irs.V, where Ers and Rrs are the respiratory system elastance and resistance, and Carboprost EEP is the endexpiratory pressure. The fitness of data to models was evaluated by the standard error of the regressions (RMSD). Comparisons between all coefficients were done at 10 and at 20 c/min with the aid of the Wilcoxon rank test (P < 0.05). Results and conclusions The mean values ?SD of all coefficients are presented in Table 1. Irs did not differ significantly between 10 and 20 c/min. The use of the inertive term results in a significantly higher Ers, lower Rrs and lower PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/6104837 RMSD (P < 0.001) at both frequencies, but these differences are clinically irrelevant. We conclude that Irs is not negligible during MV in ARDS. Respiratory pathophysiology and the ventilator characteristics may contribute to the important role of Irs during MV.Figure 2 (abstract P15)P17 Is PEEP detrimental to splanchnic perfusion in mechanically ventilated patients?M Myc, J Jastrzebski Medical Postgraduate Education Center, Warszawa, Poland Critical Care 2006, 10(Suppl 1):P17 (doi:10.1186/cc4364) Objective Disturbances in splanchnic perfusion leads to insufficiency of the gut mucosal barrier. As a consequence it causes bacterial translocation that might be a trigger to septic shock and multiorgan failure. The present study was designed to assess whether mechanical ventilation with positive end-expiratory pressure (PEEP) is a factor disturbing cardiac output and splanchnic perfusion. Gastric intramucosal PCO2 (PiCO2) and pH (pHi) are currently used as indices of the accuracy of splanchnic perfusion and as end points to guide therapeutic intervention. The definition of the ideal PEEP does not include improvement in oxygen delivery and its accessibility in the splanchnic region. Design A prospective study. Setting Department of Anesthesiology and Intensive Care of Medical Postgraduate Education Center, Warsaw, Poland. Patients Twenty ad.