The quest for optimal positive end-expiratory pressure continues

doi:10.1186/cc6208

Critical Care

Volume 12
Issue 1

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Kneyber M
van Heerde M

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van Heerde M
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Letter

The quest for optimal positive end-expiratory pressure continues

Dick Markhorst , Martin Kneyber and Marc van Heerde

Pediatric Intensive Care Unit, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands

author email corresponding author email

Critical Care 2008, 12:408doi:10.1186/cc6208


Published:	21 February 2008

See related research by Carvalho et al., http://ccforum.com/content/11/4/R86 and see related commentary by Rouby et al., http://ccforum.com/content/11/6/180

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With interest we have read the paper by Carvalho and colleagues, in which the authors report the results of their elegant study on the role of positive end-expiratory pressure (PEEP) in acute lung injury [1]. Carvalho and colleagues demonstrated in an acute respiratory distress syndrome (ARDS) model that alveolar hyperinflation and nonaerated areas may coincide during a stepwise reduction of PEEP. Their finding is in line with our findings in a mathematical ARDS model and with other studies [2,3], and emphasises that the PEEP at which the respiratory system compliance is maximal coincides with a compromise between hyperinflation and poor aeration [3].