Setting the positive expiratory-end pressure-FIO2 in acute lung injury/acute respiratory distress syndrome.

Journal Article (Journal Article;Review)

Airspace collapse is a hallmark of parenchymal lung injury. Strategies to reopen and maintain patency of these regions offer three advantages: improved gas exchange, less ventilator-induced lung injury, and improved lung compliance. Elevations in intrathoracic pressure to achieve these goals, however, may overdistend healthier lung regions and compromise cardiac function. Positive end-expiratory pressure is a widely used technique to maintain alveolar patency, but its beneficial effects must be balanced against its harmful effects. Mechanical approaches to achieve this balance are clinically difficult to do. Thus gas exchange algorithms with modest PaO2 goals are commonly used today. Recruitment maneuvers and long inspiratory time strategies may be useful adjuncts.

Full Text

Duke Authors

Cited Authors

  • MacIntyre, NR

Published Date

  • September 2004

Published In

Volume / Issue

  • 10 / 3

Start / End Page

  • 301 - v

PubMed ID

  • 15458728

Pubmed Central ID

  • 15458728

International Standard Serial Number (ISSN)

  • 1078-5337

Digital Object Identifier (DOI)

  • 10.1016/j.rcc.2004.04.006


  • eng

Conference Location

  • United States