منابع مشابه
Recruitment Maneuvers and PEEP Titration.
The injurious effects of alveolar overdistention are well accepted, and there is little debate regarding the importance of pressure and volume limitation during mechanical ventilation. The role of recruitment maneuvers is more controversial. Alveolar recruitment is desirable if it can be achieved, but the potential for recruitment is variable among patients with ARDS. A stepwise recruitment man...
متن کاملPEEP titration: new horizons.
Most respiratory practitioners agree that PEEP helps to recruit and maintain alveoli that would otherwise collapse or suffer tidal inflation and deflation. PEEP thus reduces atelectrauma, shear forces, and systemic inflammatory mediator release. These benefits are balanced against consequences. PEEP can lead to overdistention of lung units, especially those that remain normal in the midst of he...
متن کاملDead space fraction changes during PEEP titration following lung recruitment in patients with ARDS.
BACKGROUND Elevated dead space fraction (the ratio of dead space to tidal volume [V(D)/V(T)]) is a feature of ARDS. PEEP can partially reverse atelectasis, prevent alveoli recollapse, and improve lung compliance and gas exchange in patients with ARDS. However, whether V(D)/V(T) variables have a close relationship with PEEP and collapse alveolar recruitment remains under recognized. Meanwhile, f...
متن کاملRecruitment Maneuvers to the Extreme.
Alveolar collapse is a common problem in mechanically ventilated children, particularly those with significant lung disease, such as ARDS. Many different methods are used by clinicians to recruit collapsed alveoli, including sustained inflation or incremental increases in PEEP until recruitment is achieved. These methods have primarily been studied in animal models and adults with varying appro...
متن کاملDecremental PEEP titration: a step away from the table.
The setting of PEEP in patients with ARDS has become a standard of practice for nearly 46 years.1 One of the more widely used methods in current practice for PEEP selection is the ARDS Network PEEP/FIO2 table. 2 This table guides the clinician to increase or decrease PEEP and FIO2 based on oxygenation. The low-to-modest levels of PEEP utilized throughout the table have been challenged in 2 stud...
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ژورنال
عنوان ژورنال: Respiratory Care
سال: 2015
ISSN: 0020-1324,1943-3654
DOI: 10.4187/respcare.04409