PMID: 8614043Apr 1, 1996Paper

The effects of positive end-expiratory pressure of intrapulmonary shunt and ventilatory deadspace in nonhypoxic trauma patients

The Journal of Trauma
A R Vigil, F W Clevenger

Abstract

Controversy exists regarding the routine use of positive end-expiratory pressure (PEEP) in mechanically ventilated patients. We hypothesized that nonhypoxic patients receiving 5-cm H2O PEEP would have improved shunt and PaO2/F10(2) ratios (P/F), without an increased dead space to tidal volume ratio (VD/VT) versus patients receiving no PEEP. Forty-four trauma patients were randomized to receive 5-cm H2O PEEP (PEEP) or 0-cm H2O PEEP (ZEEP). Shunt VD/VT and P/F were measured at 0, 12, 24, 36, and 48 hours after intubation and after extubation. PEEP and ZEEP comparisons used Student's t test and the General Linear Models procedure. Shunt was significantly increased at t = 0 and at extubation in the PEEP group. At extubation, the PEEP group demonstrated significantly higher VD/VT and poorer P/F ratios. After correction for baseline values, no statistically significant differences were noted in spite of a trend toward worsening pulmonary function in all measured parameters. These results suggest that routine use of 5-cm H2O PEEP in mechanical ventilated trauma patients is not necessary.

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Citations

Sep 18, 2018·Anesthesia and Analgesia·Maximilian S SchaeferTanja Astrid Meyer-Treschan
May 10, 2018·Trials·Anna Geke AlgeraUNKNOWN RELAx Investigators and the PROVE Network Investigators
Jul 17, 2021·Critical Care : the Official Journal of the Critical Care Forum·Tommaso PettenuzzoPaolo Navalesi

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