[Effects of positive end-expiratory pressure on lung recruited volume and oxygenation in patients with acute respiratory distress syndrome].
OBJECTIVE
To access alveolar recruitment with positive end-expiratory pressure (PEEP) and to correlate the recruited volume with arterial oxygenation in acute respiratory distress syndrome (ARDS).


METHODS
Eleven ventilated patients satisfying criteria of ARDS were included in the study group. Recruited volume of three different PEEP levels [5 cm H2O, 10 cm H2O, 15 cm H2O (1 cm H2O=0.098 kPa)] were measured by pressure-volume curve method. Effects of different PEEP levels on lung mechanics and gas exchange were compared.


RESULTS
Lung recruited volume elevated when PEEP increased from 5 cm H2O to 15 cm H2O[(40.2+/-15.3)ml vs. (123.8+/-43.1)ml vs. (178.9+/-43.5)ml, all P<0.05]. Arterial oxygenation index increased with PEEP and a positive correlation was found between recruited volume and changes in arterial oxygenation index (r=0.483, P<0.01). There was no significant difference during the static compliance at different PEEP levels at a fixed tidal volume (P>0.05). Recruited volume at PEEP 15 cm H2O in the patient group with lower inflection point (LIP) was larger than the group without LIP.


CONCLUSIONS
Recruited volume increases with PEEP, and the PEEP-induced increase in arterial oxygenation is significantly correlated to recruited volume.
Qiu
Hai-Bo
HB
Department of Critical Care Medicine, Zhongda Hospital and School of Clinical Medicine, Southeast University, Nanjing 210009, Jiangsu, China. haiboq2000@yahoo.com.cn
Xu
Hong-Yang
HY
Yang
Yi
Y
Zhou
Shao-Xia
SX
Chen
Yong-Ming
YM
Sun
Hui-Ming
HM
D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D005260:Female; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000503:physiopathology* / Q000628:therapy