Point: Should positive end-expiratory pressure in patients with ARDS be set on oxygenation? Yes\No

Russell R. Miller; Neil R. MacIntyre; R. Duncan Hite; Jonathon D. Truwit; Roy G. Brower; Alan H. Morris; Gregory A. Schmidt

doi:10.1378/chest.12-0155

Point: Should positive end-expiratory pressure in patients with ARDS be set on oxygenation? Yes\No

Russell R. Miller, Neil R. MacIntyre, R. Duncan Hite, Jonathon D. Truwit, Roy G. Brower, Alan H. Morris, Gregory A. Schmidt

Research output: Contribution to journal › Editorial › peer-review

4 Scopus citations

Abstract

Complex techniques of managing PEEP, such as with analysis of PV relationships, suffer from several important limitations. Infl ection points on the PV curve are not tightly linked to alveolar recruitment. Moreover, these PV strategies are time consuming, diffi cult to interpret, and have yet to affect clinical outcomes. In contrast, PEEP/FIO₂ tables provide a reasonable treatment strategy, are clinically easy to use, and are amenable to widespread application. We conclude that best current ventilator practice in patients with ALI/ARDS includes a PEEP/FIO₂ table as part of a low tidal volume strategy (≤6 mL/kg predicted body weight). Although imperfect, PEEP/FIO ₂ tables are a reasonable approach.

Original language	English (US)
Pages (from-to)	1379-1382
Number of pages	4
Journal	CHEST
Volume	141
Issue number	6
DOIs	https://doi.org/10.1378/chest.12-0155
State	Published - Jun 2012
Externally published	Yes

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

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10.1378/chest.12-0155

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title = "Point: Should positive end-expiratory pressure in patients with ARDS be set on oxygenation? Yes\No",

abstract = "Complex techniques of managing PEEP, such as with analysis of PV relationships, suffer from several important limitations. Infl ection points on the PV curve are not tightly linked to alveolar recruitment. Moreover, these PV strategies are time consuming, diffi cult to interpret, and have yet to affect clinical outcomes. In contrast, PEEP/FIO2 tables provide a reasonable treatment strategy, are clinically easy to use, and are amenable to widespread application. We conclude that best current ventilator practice in patients with ALI/ARDS includes a PEEP/FIO2 table as part of a low tidal volume strategy (≤6 mL/kg predicted body weight). Although imperfect, PEEP/FIO 2 tables are a reasonable approach.",

author = "Miller, {Russell R.} and MacIntyre, {Neil R.} and Hite, {R. Duncan} and Truwit, {Jonathon D.} and Brower, {Roy G.} and Morris, {Alan H.} and Schmidt, {Gregory A.}",

year = "2012",

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language = "English (US)",

volume = "141",

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T2 - Should positive end-expiratory pressure in patients with ARDS be set on oxygenation? Yes\No

AU - Miller, Russell R.

AU - MacIntyre, Neil R.

AU - Hite, R. Duncan

AU - Truwit, Jonathon D.

AU - Brower, Roy G.

AU - Morris, Alan H.

AU - Schmidt, Gregory A.

PY - 2012/6

Y1 - 2012/6

N2 - Complex techniques of managing PEEP, such as with analysis of PV relationships, suffer from several important limitations. Infl ection points on the PV curve are not tightly linked to alveolar recruitment. Moreover, these PV strategies are time consuming, diffi cult to interpret, and have yet to affect clinical outcomes. In contrast, PEEP/FIO2 tables provide a reasonable treatment strategy, are clinically easy to use, and are amenable to widespread application. We conclude that best current ventilator practice in patients with ALI/ARDS includes a PEEP/FIO2 table as part of a low tidal volume strategy (≤6 mL/kg predicted body weight). Although imperfect, PEEP/FIO 2 tables are a reasonable approach.

AB - Complex techniques of managing PEEP, such as with analysis of PV relationships, suffer from several important limitations. Infl ection points on the PV curve are not tightly linked to alveolar recruitment. Moreover, these PV strategies are time consuming, diffi cult to interpret, and have yet to affect clinical outcomes. In contrast, PEEP/FIO2 tables provide a reasonable treatment strategy, are clinically easy to use, and are amenable to widespread application. We conclude that best current ventilator practice in patients with ALI/ARDS includes a PEEP/FIO2 table as part of a low tidal volume strategy (≤6 mL/kg predicted body weight). Although imperfect, PEEP/FIO 2 tables are a reasonable approach.

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Point: Should positive end-expiratory pressure in patients with ARDS be set on oxygenation? Yes\No

Abstract

ASJC Scopus subject areas

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