Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure
for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial.
Savian C, Chan P, Paratz J (2005) The effect of positive end-expiratory pressure
level on peak expiratory flow during manual hyperinflation.
This study, in healthy subjects, examined the effect of positive end-expiratory pressure
(PEEP) settings on the sensation of air hunger.
2] and titration of positive end-expiratory pressure
(PEEP) to optimise compliance and oxygenation (10).
ARDS Clinical Trials Network, National Heart, Lung and Blood Institute, National Institutes of Health (2003) Effects of recruitment maneuvers in patients with acute lung injury and acute respiratory distress syndrome ventilated with high positive end-expiratory pressure
Maximizes clinical outcomes by eliminating the need to interrupt ventilation, allowing positive end-expiratory pressure
(PEEP) to be maintained.
Ventilation was provided by bellows, expiration occurring through a series of flap valves and water jars to maintain positive end-expiratory pressure
IPV combines conventional positive pressure ventilation, high frequency oscillation, and external positive end-expiratory pressure
(Antonaglia et al 2006, Fig.
With pressure-triggering, a breath is initiated when the patient inspires, causing a drop below the level of the end-expiratory pressure
Gattinoni L, Carlesso E, Brazzi L, Caironi R Positive end-expiratory pressure
It also adds the necessary additional flow into the breathing circuit to help optimize breath triggering and cycling functions as well as to help maintain the set positive end-expiratory pressure
By decreasing resistance, expiratory flow can be enhanced and the tendency to dynamic hyperinflation and the development of intrinsic positive end-expiratory pressure
is reduced" (24).
2]), positive end-expiratory pressure
, peak airway pressure, dynamic lung compliance and respiratory rate.
On the day of admission to the intensive care unit, the ventilator settings were 13 cmH2O of pressure support, 5 cmH2O of positive end-expiratory pressure
and 35% FiO2.
Oxygenation is provided via mechanical ventilation: high levels of positive end-expiratory pressure
can stabilise lung units and prevent re-occlusion, whereas low Vt ventilation reduces both baro- and volutrauma (1,3).