PEEP titration during prone positioning for acute respiratory distress syndrome
No major trial evaluating prone positioning for acute respiratory distress syndrome (ARDS) has incorporated a high-positive end-expiratory pressure (high-PEEP) strategy despite complementary physiological rationales. We evaluated generalizability of three recent proning trials to patients receiving...
| Autores: | , , , , , , |
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| Tipo de documento: | artigo |
| Data de publicação: | 2015 |
| País: | España |
| Recursos: | Universitat Autònoma de Barcelona |
| Repositório: | Dipòsit Digital de Documents de la UAB |
| Idioma: | inglês |
| OAI Identifier: | oai:ddd.uab.cat:296548 |
| Acesso em linha: | https://ddd.uab.cat/record/296548 https://dx.doi.org/urn:doi:10.1186/s13054-015-1153-9 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Humans Positive-Pressure Respiration Prone Position Respiratory Distress Syndrome, Adult |
| Resumo: | No major trial evaluating prone positioning for acute respiratory distress syndrome (ARDS) has incorporated a high-positive end-expiratory pressure (high-PEEP) strategy despite complementary physiological rationales. We evaluated generalizability of three recent proning trials to patients receiving a high-PEEP strategy. All trials employed a relatively low-PEEP strategy. After protocol ventilator settings were initiated and the patient was positioned per treatment assignment, post-intervention PEEP was not more than 5 cm HO in 16.7 % and not more than 10 cm HO in 66.0 % of patients. Post-intervention PEEP would have been nearly twice the set PEEP had a high-PEEP strategy been employed. Use of either proning or high-PEEP likely improves survival in moderate-severe ARDS; the role for both concomitantly remains unknown. |
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