• Curr Opin Crit Care · Feb 2024

    Review

    Setting positive end-expiratory pressure: lung and diaphragm ultrasound.

    • Amne Mousa, Peter Klompmaker, and Pieter R Tuinman.
    • Department of Intensive Care, Amsterdam UMC location Vrije Universiteit Amsterdam.
    • Curr Opin Crit Care. 2024 Feb 1; 30 (1): 536053-60.

    Purpose Of ReviewThe purpose of this review is to summarize the role of lung ultrasound and diaphragm ultrasound in guiding ventilator settings with an emphasis on positive end-expiratory pressure (PEEP). Recent advances for using ultrasound to assess the effects of PEEP on the lungs and diaphragm are discussed.Recent FindingsLung ultrasound can accurately diagnose the cause of acute respiratory failure, including acute respiratory distress syndrome and can identify focal and nonfocal lung morphology in these patients. This is essential in determining optimal ventilator strategy and PEEP level. Assessment of the effect of PEEP on lung recruitment using lung ultrasound is promising, especially in the perioperative setting. Diaphragm ultrasound can monitor the effects of PEEP on the diaphragm, but this needs further validation. In patients with an acute exacerbation of chronic obstructive pulmonary disease, diaphragm ultrasound can be used to predict noninvasive ventilation failure. Lung and diaphragm ultrasound can be used to predict weaning outcome and accurately diagnose the cause of weaning failure.SummaryLung and diaphragm ultrasound are useful for diagnosing the cause of respiratory failure and subsequently setting the ventilator including PEEP. Effects of PEEP on lung and diaphragm can be monitored using ultrasound.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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