Positive end-expiratory pressure in acute respiratory distress syndrome: should the 'open lung strategy' be replaced by a 'protective lung strategy'?
- PMID: 18086329
- PMCID: PMC2246215
- DOI: 10.1186/cc6183
Positive end-expiratory pressure in acute respiratory distress syndrome: should the 'open lung strategy' be replaced by a 'protective lung strategy'?
Abstract
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.
Comment in
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The quest for optimal positive end-expiratory pressure continues.Crit Care. 2008;12(1):408; author reply 408. doi: 10.1186/cc6208. Crit Care. 2008. PMID: 18341706 Free PMC article. No abstract available.
Comment on
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Positive end-expiratory pressure at minimal respiratory elastance represents the best compromise between mechanical stress and lung aeration in oleic acid induced lung injury.Crit Care. 2007;11(4):R86. doi: 10.1186/cc6093. Crit Care. 2007. PMID: 17688701 Free PMC article.
References
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- Carvalho AR, Jandre FC, Pino AV, Bozza FA, Salluh JI, Rodrigues R, Ascoli FO, Giannella-Neto A. Positive end-expiratory pressure at minimal respiratory elastance represents the best compromise between mechanical stress and lung aeration in oleic acid induced lung injury. Crit Care. 2007;11:R86. doi: 10.1186/cc6093. - DOI - PMC - PubMed
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- Muscedere JG, Mullen JB, Gan K, Slutsky AS. Tidal ventilation at low airway pressures can augment lung injury. Am J Respir Crit Care Med. 1994;149:1327–1334. - PubMed
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