Effects of PEEP above the L-Pflex on gas exchange, hemodynamic and gastric tonometry in ARDS patients

Full text

PEEP titrated by the L-Pflex of static PxV curve of respiratory system improved oxygenation and mortality in ARDS patients. In order to study the acute effects of PEEP on oxygenation, CO₂ exchange, hemodynamic parameters and gastric tonometry we analyzed six ARDS patients (<5 days of installation) after 30 min on PEEP of 5 cmH₂O, then 30 min on PEEP 2 cmH₂O above the L-Pflex and then30 min after PEEP of 5 cmH₂O again. They were allsedated and paralyzed. A Swan-Ganz catheter with a continuos cardiac output (Baxter^®) and a continuos gastric tonometer (Tonocap^®) were inserted in each patient. The tidal volume and respiratory rate were kept constant (8 ml/kg and 20/min- VCV-Ventilation-Servo-Siemens-300). L-Pflex was titrated by the static PxV curve of the respiratory system (random volumes).

Results

See Table.

Conclusion

PEEP titrated by the L-Pflex of the static PxV curve of the respiratory system improved oxygenation without impairing global as well as regional hemodynamic parameters in ARDS patients.

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