Can heterogeneity in ventilation be good?
Selection of the optimal positive end-expiratory pressure (PEEP) to avoid ventilator-induced lung injury in patients under mechanical ventilation is still a matter of debate. Many methods are available, but none is considered the gold standard. In the previous issue of Critical Care, Zhao and colleagues applied a method based on electrical impedance tomography to help select the PEEP that minimized ventilation inhomogeneities. Though promising when alveolar collapse and overdistension are present, this method might be misleading in patients with normal lungs.
Costa
Eduardo L V
EL
Research and Education Institute, Hospital Sírio Libanês, Rua Cel, Nicolau dos Santos, São Paulo, SP, Brazil. eduardoleitecosta@gmail.com
Amato
Marcelo B P
MB
D002755:Choice Behavior; D016638:Critical Illness; D017097:Electric Impedance; D006801:Humans; D055370:Lung Injury / Q000517:prevention & control; D011175:Positive-Pressure Respiration / Q000379:methods*