tailieunhanh - Báo cáo y học: " Positive end-expiratory pressure or no positive end-expiratory pressure: is that the question to be asked"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: Positive end-expiratory pressure or no positive end-expiratory pressure: is that the question to be asked? | Critical Care April 2003 Vol 7 No 2 Villar Letter Positive end-expiratory pressure or no positive end-expiratory pressure is that the question to be asked Jesus Villar Director Research Institute Hospital NS de Candelaria Tenerife Canary Islands Spain Correspondence Dr Jesús Villar Published online 20 January 2003 Critical Care 2003 7 192 DOI cc1878 This article is online at http content 7 2 192 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Positive end-expiratory pressure PEEP is an essential technique for the respiratory care of many critically ill patients who require ventilatory support. With the application of PEEP the baseline end-expiratory pressure in mechanically ventilated patients is elevated above atmospheric pressure. In general the application of PEEP is expected to improve lung mechanics and gas exchange as it recruits lung volume in selected patients. During the past three decades research on the effects of PEEP in animal models of acute lung injury and in patients with acute respiratory failure has produced a plethora of information. In the present issue of Critical Care Forum Fernández-Mondejar and colleagues 1 comment that there is a need for clinical studies to reassess the value of prophylactic PEEP. Although numerous approaches to the application of PEEP have been described no controlled studies demonstrating the best method of choosing the level of PEEP have been published to date. Although the optimal method of applying PEEP is still controversial it is generally agreed that simply using increased arterial partial pressure of oxygen as the end point is inappropriate. Although recent reports have supported the beneficial effects of relatively high levels of PEEP on morbidity and mortality in patients with acute lung injury it is still not clear how much PEEP is required in the ventilatory management of patients with acute respiratory failure. In practice PEEP has been used in