tailieunhanh - Báo cáo y học: " Positive end-expiratory pressure in acute respiratory distress syndrome – an old yet mysterious too"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Positive end-expiratory pressure in acute respiratory distress syndrome – an old yet mysterious too. | Critical Care October 2004 Vol 8 No 5 Calzia and Radermacher Commentary Positive end-expiratory pressure in acute respiratory distress syndrome - an old yet mysterious tool Enrico Calzia1 and Peter Radermacher2 1Staff Anesthesiologist Sektion Anasthesiologische Pathophysiologie u. Verfahrensentwicklung Universitatsklinik fur Anasthesiologie Universitat Ulm Ulm Germany 2Professor of Anesthesiology Sektion Anasthesiologische Pathophysiologie u. Verfahrensentwicklung Universitatsklinik fur Anasthesiologie Universitat Ulm Ulm Germany Corresponding author Enrico Calzia Published online 16 July 2004 Critical Care 2004 8 308-309 DOI cc2914 This article is online at http content 8 5 308 2004 BioMed Central Ltd Related to Research by Bruhn et al. see page 395 Abstract A recent study by Bruhn and colleagues discussed here confirms that even high levels of positive end-expiratory pressure PEEP - up to 20 cmH2O - may be applied in conditions of moderate acute respiratory distress syndrome. Such levels of PEEP were found to be safe in terms of their impact on cardiac output and adequacy of gastric mucosal perfusion once systemic haemodynamics were stabilized by adequate fluid replacement and catecholamine therapy. However we strongly recommend that the reader does not oversimplify the conclusions of that study. PEEP therapy is not inherently safe with respect to haemodynamics and regional organ perfusion but it may be used safely even at high levels of up to 20 cmH2O if haemodynamic therapy is appropriate. Keywords acute lung injury acute respiratory distress syndrome mechanical ventilation Pco2 gap positive end-expiratory pressure regional organ perfusion The introduction of positive end-expiratory pressure PEEP into the practice of mechanical ventilation in patients with acute respiratory distress syndrome ARDS 1 was among the most important milestones in critical care therapy. However despite the clear benefits of this .