[A new indicator to determine the optimal PEEP (author's transl)].
To elucidate the optimal PEEP for respiratory treatment, respiratory and haemodynamic studies were performed on 12 normovolemic patients with ARDS for various levels of PEEP (PEEP = 0, 5, 10, 20 cm H2O). In this study, it became clear, that Suter's best PEEP (maximal O2 transport should be taken as a reference for optimal PEEP) cannot be used in practice because O2 transport is usually maximal in ZEEP (PEEP=0) and changes with the alteration of FIO2. We propose "intrapulmonary nonshunt flow ((Qt-Qs)" as a new indicator to determine the optimal PEEP. The level of PEEP to achieve the maximal intrapulmonary non-shunt flow must be such that the decrease in intrapulmonary shunt flow is attained with minimal decrease of cardiac output.
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000628:therapy*; D013318:Stroke Volume
D010100:Oxygen
Ein neuer Index zur Bestimmung des optimalen PEEP .