With volume ventilation, airway pressure increases during inspiration as volume is delivered. The peak inspiratory pressure (PIP) varies directly with resistance, end-inspiratory flow, VT and elastance (ie, inversely with compliance). An end-inspiratory pause of sufficient duration (0.5 to 2.0 s) allows equilibration between proximal airway pressure and alveolar pressure. This manoeuvre should be applied on a single breath and removed immediately to prevent development of auto-PEEP. During the end-inspiratory pause, there is no flow and a pressure plateau (Pplat) develops as proximal airway pressure equilibrates with alveolar pressure. The pressure during the inspiratory pause is commonly referred to as plateau pressure and represents peak alveolar pressure. The difference between PIP and the Pplat is due to the resistive properties of the system (eg, pulmonary airways, artificial airway), and the difference between Pplat and total PEEP is due to the elastic properties of the system (ie, lung and chest wall compliance). Safe online shopping for drugs: cialis professional online to make your *drugs cheaper.