PMID: 22333124Feb 16, 2012Paper

Dead space guided positive end-expiratory pressure in patients with acute respiratory distress syndrome

Zhonghua nei ke za zhi
Song-Qiao LiuYi Yang

Abstract

To evaluate the value of dead space fraction (V(D)/V(T)) guided positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS). Twenty-three intubated and mechanically ventilated patients with early ARDS were enrolled in the study. PEEP was titrated by lowest V(D)/V(T). Parameters of oxygenation and respiratory mechanics were observed. PEEP titrated by lowest V(D)/V(T) and highest static lung compliance (C(Lst)) (P > 0.05) respectively, were lower than PEEP titrated by optimal oxygenation (P < 0.05), but there was no significant difference between lowest V(D)/V(T) and highest C(Lst) method. The V(D)/V(T) that ventilated on PEEP titrated by the lowest V(D)/V(T) decreased than its basal level. There was no difference significantly between the V(D)/V(T) that ventilated on PEEP elected by the other two methods with basal level (P > 0.05). The the ratio of arterial PO2 to the inspired oxygen fraction (PaO2/FiO2) ratios improved significantly than the baseline values in three ventilation strategies, and that ventilated on PEEP targeting the lowest V(D)/V(T) was lower than PEEP targeting optimal oxygenation. The plateau airway pressure that ventilated on PEEP targeting optimal oxygenation was higher than the oth...Continue Reading

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