PEEP and "reverse mismatch". A case where less PEEP is best.
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 H2O, a repeat V/Q scan showed a more even distribution of pulmonary perfusion. Arterial hypoxemia improved.
Hawker
F H
FH
Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Torzillo
P J
PJ
Southee
A E
AE
D000368:Aged; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011175:Positive-Pressure Respiration / Q000009:adverse effects* / Q000379:methods; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging / Q000628:therapy*; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D011877:Radionuclide Imaging; D016284:Technetium Tc 99m Pentetate; D014692:Ventilation-Perfusion Ratio / Q000502:physiology
D016284:Technetium Tc 99m Pentetate