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November 2004, Volume 34 Number 11 , p 32cc4 - 32cc4




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    Clinical outcomes are about the same for patients with acute lung injury and acute respiratory distress syndrome who receive high or low levels of positive end-expiratory pressure (PEEP), according to a recent study.

    Researchers randomly assigned 549 patients to receive mechanical ventilation with high (average 13 cm H 2 O) or low (average 8 cm H 2 O) levels of PEEP. The tidal volume goal was 6 ml/kg of predicted body weight and an end-inspiratory plateau-pressure limit of 30 cm H 2 O. Higher levels of PEEP may improve oxygenation, but also may cause lung injury. Among patients in the low-PEEP group, 24.9% died, compared with 27.5% of those in the high-PEEP group.


    “Higher versus Lower Positive End-Expiratory Pressures in Patients with the Acute Respiratory Distress Syndrome,” The New England Journal of Medicine , R. Brower, et al., The National Heart, Lung, and Blood Institute ARDS Clinical Trials ...

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