Optimal positive-end expiratory pressure weaning in acute respiratory distress syndrome patients

被引：0

作者：

Mcnamara, Laura ^{[1
]}

Kassis, Elias Baedorf ^{[1
,2
,3
]}

机构：

[1] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Div Pulm & Crit Care, Boston, MA USA

[2] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Anesthesia Pain & Crit Care, Boston, MA USA

[3] 375 Longwood Ave, Boston, MA 02115 USA

来源：

CURRENT OPINION IN CRITICAL CARE | 2024年 / 30卷 / 01期

关键词：

acute respiratory distress syndrome; mechanical ventilation; positive-end expiratory pressure; weaning; ACUTE LUNG INJURY; MECHANICAL VENTILATION; TIDAL VOLUMES;

D O I：

10.1097/MCC.0000000000001122

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose of reviewPositive-end expiratory pressure (PEEP) is a tool in managing acute respiratory distress syndrome (ARDS). In this review, we discuss the various approaches to weaning PEEP after the acute phase of ARDS.Recent findingsThere is a paucity of research specifically looking at the differences between PEEP weaning protocols. Data in some populations though, particularly those with elevated BMI, suggest that a physiologic approach to PEEP weaning may be helpful. Use of various tools to optimize PEEP prior to and during spontaneous breathing trials (SBTs) may allow for improved alveolar recruitment and respiratory outcomes.SummaryAlthough further prospective studies are warranted, we should consider using a physiologic approach to PEEP weaning in ARDS rather than a one size fits all model, which is currently the standard used in many clinical trials and throughout many ICUs.

引用

页码：85 / 88

页数：4

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