• Medicina intensiva · Nov 2014

    Individualized positive end-expiratory pressure application in patients with acute respiratory distress syndrome.

    • M C Pintado and R de Pablo.
    • Unidad de Cuidados Intensivos, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España. Electronic address: consuelopintado@yahoo.es.
    • Med Intensiva. 2014 Nov 1; 38 (8): 498-501.

    AbstractCurrent treatment of acute respiratory distress syndrome is based on ventilatory support with a lung protective strategy, avoiding the development of iatrogenic injury, including ventilator-induced lung injury. One of the mechanisms underlying such injury is atelectrauma, and positive end-expiratory pressure (PEEP) is advocated in order to avoid it. The indicated PEEP level has not been defined, and in many cases is based on the patient oxygen requirements for maintaining adequate oxygenation. However, this strategy does not consider the mechanics of the respiratory system, which varies in each patient and depends on many factors-including particularly the duration of acute respiratory distress syndrome. A review is therefore made of the different methods for adjusting PEEP, focusing on the benefits of individualized application. Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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