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- W2361852003 abstract "Objective:To assess the ability of a decremental trial of positive end-expiratory pressure(PEEP)to identify an optimal PEEP level that maintains oxygenation after a lung-recruitment maneuver.Method:This is a prospective and self-controlled clinical trial.22 sedated patients with acute lung injury and/or acute respiratory distress syndrome,ventilated for 1.2±0.4days.Each patient received up to 3 lung-recruitment maneuvers with continuous positive airway pressure of 40cmH2O sustained for 40s to increase the ratio of PaO2 to FiO2 by20%.Following the lung-recruitment maneuver,PEEP was set at 20cmH2O and then the FiO2 was decreased until the SpO2(measured via pulse oximetry)was 90-94%.PEEP was then decreased in 2cmH2O steps until the SpO2 dropped below 90%.The step preceding the drop to below 90% was considered the optimal PEEP.The lung was then re-recruited and PEEP and FiO2 were set at the identified levels.The patients were followed up for 6 hours after the PEEP trial and the setting of PEEP and FiO2.Result:After the lung-recruitment maneuver,all the patients' PaO2/FiO2 increased 50%.The PaO2/FiO2 on the optimal decremental trial PEEP was 211±79mmHg,versus 135±37 mmHg at baseline(P 0.001),and was sustained at that level for 6 hous(227±81 mmHg at 6 hours).FiO2 at baseline was 0.54 ±0.12 versus 0.38 ±0.12(P 0.001)at 6 hours.PEEP was 11.9±3.0 cmH2O at baseline and 9.1±4.7 cmH2O(P0.011)at 6 hours.Conclusion:A decremental PEEP trial identifies a PEEP setting that sustains for 6 hours the oxygenation benefit of 40cmH2O,40s lung-recruitment maneuver." @default.
- W2361852003 created "2016-06-24" @default.
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- W2361852003 date "2010-01-01" @default.
- W2361852003 modified "2023-09-24" @default.
- W2361852003 title "A Decremental PEEP Trial Identifies the PEEP Level that Maintains Oxygenation after Lung Recruitment" @default.
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