Is there a best way to set positive expiratory-end pressure for mechanical ventilatory support in acute lung injury?

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 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 expiratory-end pressure is a widely used technique to maintain alveolar patency, but its beneficial effects must be balanced against its harmful effects.

Duke Scholars

Author Neil Ross MacIntyre Jr. Medicine, Pulmonary, Allergy, and Critical Care Medicine