Pediatric research
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Positive end-expiratory pressure (PEEP) has become a mainstay in the treatment of hypoxemic acute respiratory failure (ARF). Whereas PEEP improves arterial oxygen tension by decreasing intrapulmonary shunting, it may also impair cardiac output and hence decrease systemic oxygen transport. Inasmuch as optimizing oxygen transport is a goal of therapy in ARF, we sought to determine if the level of PEEP that results in maximal oxygen transport could be estimated from measurements of compliance of the respiratory system (Crs) or PaO2. ⋯ At levels of PEEP above that associated with maximal oxygen transport, CI and oxygen transport fell significantly, while PaO2 continued to rise. No relationship between Crs and oxygen transport was observed. In our normovolemic patients with ARF, neither PaO2 nor Crs predicted PEEP of maximal oxygen transport.(ABSTRACT TRUNCATED AT 250 WORDS)