Is there a best way to set positive expiratory-end pressure for mechanical ventilatory support in acute lung injury?
Airspace collapse is a hallmark of parenchymal lung injury. Strategies to reopen and maintain patency of these regions offer three advantages: improved gas exchange, less lung injury, and improved lung compliance. Elevations in intrathoracic pressure to achieve these goals, however, may overdistend healthier lung regions and compromise cardiac function. Positive expiratory-end pressure is a widely used technique to maintain alveolar patency, but its beneficial effects must be balanced against its harmful effects.
MacIntyre
Neil R
NR
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Box 3911, Room 1120, Erwin Road, Durham, NC 27710, USA. neil.macintyre@duke.edu
D006801:Humans; D011175:Positive-Pressure Respiration / Q000592:standards*; D011650:Pulmonary Alveoli / Q000502:physiology; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy*; D012122:Ventilators, Mechanical