How I set up positive end-expiratory pressure: evidence- and …
2019年12月16日 · Simultaneously, if C RS decreases when PEEP is increased, indicating overdistension, we reduce either PEEP or V T (if feasible in terms of CO 2 elimination and respiratory rate). For a safe plateau pressure ( P plat ), one size (i.e., 30 cmH 2 O) does not fit all, and if overdistension is an issue, our safety threshold for P plat is decreased.
Positive end-expiratory pressure management in patients with …
2024年8月26日 · The optimal strategy for positive end-expiratory pressure (PEEP) titration in the management of severe acute respiratory distress syndrome (ARDS) patients remains unclear. Current guidelines emphasize the importance of a careful risk–benefit assessment for PEEP titration in terms of cardiopulmonary function in these patients. Over the last few decades, the …
PEEP levels in COVID-19 pneumonia | Critical Care | Full Text
2020年6月6日 · After measuring respiratory mechanics, arterial blood gases, and hemodynamics, we decreased PEEP by 25–30% (other mechanical ventilation variables remained stable). We re-evaluated measurements (1 h later) focusing on the effects of PEEP reduction on respiratory mechanics, hemodynamics, and fluid balance in a 12-h window before and after the ...
Electric impedance tomography-guided PEEP titration reduces …
2023年1月17日 · Background In patients with acute respiratory distress syndrome undergoing mechanical ventilation, positive end-expiratory pressure (PEEP) can lead to recruitment or overdistension. Current strategies utilized for PEEP titration do not permit the distinction. Electric impedance tomography (EIT) detects and quantifies the presence of both collapse and …
Dynamic hyperinflation and intrinsic positive end-expiratory …
2019年11月27日 · Background In ARDS patients, changes in respiratory mechanical properties and ventilatory settings can cause incomplete lung deflation at end-expiration. Both can promote dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEP). The aim of this study was to investigate, in a large population of ARDS patients, the presence of intrinsic …
Effects of different positive end-expiratory pressure titration ...
2022年3月26日 · Background Prone positioning in combination with the application of low tidal volume and adequate positive end-expiratory pressure (PEEP) improves survival in patients with moderate to severe acute respiratory distress syndrome (ARDS). However, the effects of PEEP on end-expiratory transpulmonary pressure (Ptpexp) during prone positioning require …
Higher versus lower positive end-expiratory pressure in patients ...
2021年7月15日 · Background We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the association of higher positive end-expiratory pressure (PEEP), as opposed to lower PEEP, with hospital mortality in adult intensive care unit (ICU) patients undergoing invasive mechanical ventilation for reasons other than acute …
Early individualized positive end-expiratory pressure guided by ...
2021年6月30日 · Background Individualized positive end-expiratory pressure (PEEP) by electrical impedance tomography (EIT) has potential interest in the optimization of ventilation distribution in acute respiratory distress syndrome (ARDS). The aim of the study was to determine whether early individualized titration of PEEP with EIT improved outcomes in patients with ARDS. Methods A …
[8–10]. In these situations, “optimal” PEEP may dier and warrant careful re-titration to balance potential benets and harms. is article reviews PEEP management in patients with severe ARDS, focusing on the physiological eects of personalized PEEP with respect to respiratory mechan-ics and cardiopulmonary function, and the implications
Comparison of electrical impedance tomography, blood gas …
2024年10月22日 · PaO 2 exhibited a non-linear relationship with PEEP changes and did not correlate strongly with collapse (Fig. 1A). As PEEP was reduced, over-distension decreased, while Vd/Vt increased (Fig. 1B). Lung compliance peaked at PEEP of 16 cmH 2 O, while the sum of collapse and over-distension was minimized at PEEP of 18 cmH 2 O (Fig. 1C).