PEEP titration during prone positioning for acute respiratory distress syndrome
Beitler, Jeremy R. (University of California)
Guérin, Claude (Université de Lyon)
Ayzac, Louis (Hôpital Henri Gabrielle)
Mancebo, Jordi (Institut d'Investigació Biomèdica Sant Pau)
Bates, Dina M. (University of California)
Malhotra, Atul (University of California)
Talmor, Daniel (Beth Israel Deaconess Cancer Center (Boston, Estats Units d'Amèrica))
Universitat Autònoma de Barcelona

Date:	2015
Abstract:	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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Humans ; Positive-Pressure Respiration ; Prone Position ; Respiratory Distress Syndrome, Adult
Published in:	Critical care, Vol. 19 Núm. 1 (december 2015) , p. 436, ISSN 1466-609X

DOI: 10.1186/s13054-015-1153-9
PMID: 26686509

6 p, 475.6 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles