What could cause elevated plateau pressures during ventilation?

Elevated plateau pressures during mechanical ventilation indicate a rise in pressure within the lungs at the end of inspiration, often linked to reduced lung compliance. In the case of pneumonia, the lung tissue becomes inflamed and filled with fluid, which interferes with normal lung expansion. This results in decreased compliance, meaning the lungs require higher pressures to achieve the same volume of air. As a consequence, plateau pressures increase due to the stiffer lung mechanics associated with pulmonary infection or consolidation.

Inadequate fluid resuscitation, reduced tidal volumes, and high-frequency oscillation ventilation may not necessarily cause elevated plateau pressures. Inadequate fluid resuscitation typically relates to cardiovascular stability rather than directly affecting lung compliance. Reduced tidal volumes might reduce plateau pressures since lower volumes could generate less resistance and pressure within the airways. High-frequency oscillation ventilation operates differently, maintaining lower airway pressures through rapid, small tidal volumes, which can also prevent elevated plateau pressures.