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Comment
. 2019 Dec 11;23(1):404.
doi: 10.1186/s13054-019-2689-x.

High PEEP may have reduced injurious transpulmonary pressure swings in the ROSE trial

João B Borges  1 , Caio C A Morais  2 , Eduardo L V Costa  2
Affiliations
Comment

High PEEP may have reduced injurious transpulmonary pressure swings in the ROSE trial

João B Borges et al. Crit Care. .
No abstract available

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Intensity of spontaneous effort with low vs. high positive end-expiratory pressure (PEEP) in an experimental model of severe acute respiratory distress syndrome. a Representative waveforms of airway pressure (PAW), esophageal pressure (PES), and electrical activity of the diaphragm (EAdi). Note that the magnitude of the negative swings of esophageal pressure was reduced by approximately 50% when PEEP was increased from 7 cmH2O (low PEEP/FIO2 table, corresponding to lung collapse = 21%) to 15 cmH2O [PEEP level individually titrated by electrical impedance tomography (EIT), corresponding to lung collapse < 1%], with similar EAdi. b A zoom into the shaded areas that highlight the induced neuromechanical uncoupling when PEEP was increased, that is, less pressure generated by the respiratory muscles (PMUS) for each microvolt of electrical activity (PMUS/EAdi index during low and high PEEP = 1.33 cmH2O/μV vs. 0.6 cmH2O/μV, respectively)
See this image and copyright information in PMC

Comment on

  • High Positive End-Expiratory Pressure Renders Spontaneous Effort Noninjurious.
    Morais CCA, Koyama Y, Yoshida T, Plens GM, Gomes S, Lima CAS, Ramos OPS, Pereira SM, Kawaguchi N, Yamamoto H, Uchiyama A, Borges JB, Vidal Melo MF, Tucci MR, Amato MBP, Kavanagh BP, Costa ELV, Fujino Y. Morais CCA, et al. Am J Respir Crit Care Med. 2018 May 15;197(10):1285-1296. doi: 10.1164/rccm.201706-1244OC. Am J Respir Crit Care Med. 2018. PMID: 29323536 Free PMC article.

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