Recenti progressi in medicina
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Review
[Use of positive end-expiratory pressure in acute respiratory distress syndrome: current views].
Despite its wide application during mechanical ventilation of patients with acute respiratory distress syndrome, the correct setting of positive end-expiratory pressure is still an unsolved issue. We have recently observed that PEEP response is strictly correlated to the amount of the potentially recruitable lung, which is in turn associated to the overall severity of lung injury. Assessment of the potential for lung recruitment is therefore necessary for the correct setting of PEEP: a high PEEP level should be limited only to patients with a higher amount of potentially recruitable lung. At present, computed tomography represents the most accurate technique for its measurement.
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In the recent years, we have witnessed a new revolution in the field of communication through Internet. Web 2.0, whose contents are provided by the collaboration, discussion, and sharing between more users, is replacing the traditional web (the web 1.0). The use of podcasts, wikis, and blogs is rapidly increasing, and today they are proposed as educational tools for health professionals, physicians, and medical students. ⋯ This could make the contents unreliable and inaccurate, and could introduce risks for a correct medical education and for the health of those patients deciding to follow the medical advice included. Studies are needed to evaluate limits, benefits, and efficacy of these tools when used in the contexts of medical education and clinical practice. Other studies are needed to evaluate the reliability and the accuracy of the medical contents posted online through the web 2.0 services.