Positive end-expiratory pressure in acute respiratory distress syndrome: should the 'open lung strategy' be replaced by a 'protective lung strategy'?
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* Corresponding author: Jean-Jacques Rouby jjrouby.pitie@invivo.edu
1 Professor of Anaesthesia and Critical Care, Head of Surgical Intensive Care Unit, Réanimation Chirurgicale Polyvalente Pierre Viars, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie of Paris – 6, 47/83 boulevard de l'Hôpital, 75651 Paris Cédex 13, France
2 Research Fellow, Department of Anesthesiology, Faculdade de Medicina da Universidade Estadual Paulista Julio de Mesquita Filho, Botucatu, Brazil
3 Praticien Hospitalier, Surgical Intensive Care Unit, Réanimation Chirurgicale Polyvalente Pierre Viars, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie of Paris – 6, 47/83 boulevard de l'Hôpital, 75651 Paris Cédex 13, France
4 Praticien Hospitalier, Surgical Intensive Care Unit, Director of Research, Réanimation Chirurgicale Polyvalente Pierre Viars, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie of Paris – 6, 47/83 boulevard de l'Hôpital, 75651 Paris Cédex 13, France
Critical Care 2007, 11:180 doi:10.1186/cc6183
Published: 11 December 2007Abstract
In patients with acute respiratory distress syndrome, positive end-expiratory pressure is associated with alveolar recruitment and lung hyperinflation despite the administration of a low tidal volume. The best positive end-expiratory pressure should correspond to the best compromise between recruitment and distension, a condition that coincides with the best respiratory elastance.