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

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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).

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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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Barbas, C., Silva, E., Hoelz, C. et al. Effects of PEEP above the L-Pflex on gas exchange, hemodynamic and gastric tonometry in ARDS patients. Crit Care 4, P122 (2000). https://doi.org/10.1186/cc842

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Keywords

  • Public Health
  • Catheter
  • Cardiac Output
  • Respiratory Rate
  • Emergency Medicine