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- Open Access
Dead space fraction indicates the titration of optimal positive end-expiratory pressure after recruitment in acute respiratory distress syndrome
© Yang et al. 2011
- Published: 1 March 2011
- Public Health
- Emergency Medicine
- Respiratory Distress
- Respiratory Distress Syndrome
- Distress Syndrome
The objective of this study is to evaluate the value of dead space fraction (VD/VT) as a method for indicating the optimal PEEP titration.
Twenty-three patients with ARDS were enrolled in the study. After lung recruitment using sustained inflation (SI), the optimal PEEP was respectively titrated by the optimal oxygenation, the maximum static pulmonary compliance (Cst), and the lowest VD/VT. The influence of these methods on oxygenation, Cst, VD/VT and FRC were observed.
The PEEP level titrated by the lowest VD/VT (10.1 ± 2.8 cmH2O) had no significant difference from the PEEP level titrated by the maximum Cst (11.3 ± 2.5 cmH2O) (P > 0.05). However, the PEEP level titrated by the lowest VD/VT was significantly lower than that determined by optimal oxygenation (P < 0.05). The oxygenation at the PEEP titrated by VD/VT was significantly lower than the optimal oxygenation, but no significant difference in PaO2/FiO2 was observed between the PEEP titrated by the lowest VD/VT and the maximum Cst. Additionally, the VD/VT and the FRC at the PEEP chosen by the three methods also had no significant difference.
The lowest VD/VT could be one of the methods to choose the optimal PEEP in ARDS patients.
- Ware LB, et al.: N Engl J Med. 2000, 342: 1334-1349. 10.1056/NEJM200005043421806View ArticlePubMedGoogle Scholar
- Meade MO, et al.: JAMA. 2008, 299: 637-645. 10.1001/jama.299.6.637View ArticlePubMedGoogle Scholar
- Rubenfeld GD: JAMA. 2010, 303: 883-884. 10.1001/jama.2010.226View ArticlePubMedGoogle Scholar
- Rouby JJ, et al.: Am J Respir Crit Care Med. 2002, 165: 1182-1186.View ArticlePubMedGoogle Scholar
- Tusman G, et al.: Intensive Care Med. 2006, 32: 1863-1871. 10.1007/s00134-006-0371-7View ArticlePubMedGoogle Scholar
- Bernard GR, et al.: Am J Respir Crit Care Med. 1994,149(3 Pt 1):818-824.View ArticlePubMedGoogle Scholar
- Gattinoni L, et al.: N Engl J Med. 2006, 354: 1775-1786. 10.1056/NEJMoa052052View ArticlePubMedGoogle Scholar
- Takeuchi M, et al.: Anesthesiology. 2002, 97: 682-692. 10.1097/00000542-200209000-00023View ArticlePubMedGoogle Scholar
- Borges JB, et al.: Am J Respir Crit Care Med. 2006, 174: 268-278. 10.1164/rccm.200506-976OCView ArticlePubMedGoogle Scholar
- Gattinoni L, et al.: Eur Respir J Suppl. 2003, 47: 15s-25s. 10.1183/09031936.03.00021303View ArticlePubMedGoogle Scholar
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