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Curr Opin Crit Care · Feb 2024
ReviewOptimal positive-end expiratory pressure weaning in acute respiratory distress syndrome patients.
- Laura McNamara and Elias Baedorf Kassis.
- Division of Pulmonary and Critical Care.
- Curr Opin Crit Care. 2024 Feb 1; 30 (1): 858885-88.
Purpose Of ReviewPositive-end expiratory pressure (PEEP) is a tool in managing acute respiratory distress syndrome (ARDS). In this review, we discuss the various approaches to weaning PEEP after the acute phase of ARDS.Recent FindingsThere is a paucity of research specifically looking at the differences between PEEP weaning protocols. Data in some populations though, particularly those with elevated BMI, suggest that a physiologic approach to PEEP weaning may be helpful. Use of various tools to optimize PEEP prior to and during spontaneous breathing trials (SBTs) may allow for improved alveolar recruitment and respiratory outcomes.SummaryAlthough further prospective studies are warranted, we should consider using a physiologic approach to PEEP weaning in ARDS rather than a one size fits all model, which is currently the standard used in many clinical trials and throughout many ICUs.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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