A Case Where Less PEEP is Best
نویسنده
چکیده
A V/Q lung scan was obtained in a patient with LLL collapse who was receiving IPPV and PEEP. This revealed absent ventilation and hyperperfusion to the collapsed lobe. After a reduction in PEEP from 12 to 5 cm H O, a repeat V/Q scan showed a more even distribution of pulmonary perfusion. Arterial hypoxemia improved. (Chest 1991; 99:1034-36) D espite continuing controversy regarding the most appropriate level of PEEP,’ it remains widely held that PEEP is useful to patients with acute respiratory failure;2 however, it is recognized that PEEP may adversely affect pulmonary gas exchange in some patients with asymmetric pulmonary disease, ’ independent ofits well-known adverse effects of reducing cardiac output and predisposing to barotrauma. We present a case which highlights the likely mechanism for this phenomenon.
منابع مشابه
استفاده همزمان از دو ونتیلاتور برای درمان عوارض ریوی ناشی از تهویه مکانیکی در بیمار مولتیپل تروما: گزارش مورد
Background and Objective: Some of multiple trauma patients admitted in ICU (Intensive Care Unit) are intubated and ventilated by mechanical ventilation. These patients are prone to many complications such as lung disease. Reasons for this complication are patients without any movement, incomplete cough reflex, GI aspiration and then not a good pulmonary discharge prone the lungs of patients to ...
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Positive end-expiratory pressure (PEEP) and inspired oxygen fraction (F(IO(2))) are the primary means of improving P(aO(2)) during mechanical ventilation. Patients with acute respiratory distress syndrome (ARDS) typically present with a large intrapulmonary shunt, which makes even high F(IO(2)) ineffective in improving P(aO(2)). PEEP decreases intrapulmonary shunt by recruiting collapsed alveol...
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