Positive end-expiratory pressure in acute respiratory distress syndrome: should the 'open lung strategy' be replaced by a 'protective lung strategy'?
نویسندگان
چکیده
In patients with acute respiratory distress syndrome, positive end-expiratory pressure is associated with alveolar recruitment and lung hyperinflation despite the administration of a low tidal volume. The best positive end-expiratory pressure should correspond to the best compromise between recruitment and distension, a condition that coincides with the best respiratory elastance.
منابع مشابه
Lung protection strategy as an effective treatment in acute respiratory distress syndrome
Lung protection strategy as an effective treatment in acute respiratory distress syndrome
متن کاملIndividualized positive end-expiratory pressure application in patients with acute respiratory distress syndrome.
Current treatment of acute respiratory distress syndrome is based on ventilatory support with a lung protective strategy, avoiding the development of iatrogenic injury, including ventilator-induced lung injury. One of the mechanisms underlying such injury is atelectrauma, and positive end-expiratory pressure (PEEP) is advocated in order to avoid it. The indicated PEEP level has not been defined...
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OBJECTIVE The open lung approach is a mechanical ventilation strategy involving lung recruitment and a decremental positive end-expiratory pressure trial. We compared the Acute Respiratory Distress Syndrome network protocol using low levels of positive end-expiratory pressure with open lung approach resulting in moderate to high levels of positive end-expiratory pressure for the management of e...
متن کاملAnatomical and functional intrapulmonary shunt in acute respiratory distress syndrome.
OBJECTIVES The lung-protective strategy employs positive end-expiratory pressure to keep open otherwise collapsed lung regions (anatomical recruitment). Improvement in venous admixture with positive end-expiratory pressure indicates functional recruitment to better gas exchange, which is not necessarily related to anatomical recruitment, because of possible global/regional perfusion modificatio...
متن کاملPositive end-expiratory pressure increases strain in patients with ALI/ARDS.
OBJECTIVE The objective of this study was to assess the effects of positive end-expiratory pressure on recruitment, cyclic recruitment and derecruitment and strain in patients with acute lung injury and acute respiratory distress syndrome using lung computed tomography. METHODS This is an open, controlled, non-randomized interventional study of ten patients with acute lung injury and acute re...
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ورودعنوان ژورنال:
- Critical Care
دوره 11 شماره
صفحات -
تاریخ انتشار 2007