Prospective observational study to evaluate the effect of different levels of positive end-expiratory pressure on lung mechanics in patients with and without acute respiratory distress syndrome
Background: The optimal level of positive end-expiratory pressure is still under debate. There are scare data examining the association of PEEP with transpulmonary pressure (TPP), end-expiratory lung volume (EELV) and intraabdominal pressure in ventilated patients with and without ARDS. Methods: We...
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| Hauptverfasser: | , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
31 July 2020
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| In: |
Journal of Clinical Medicine
Year: 2020, Jahrgang: 9, Heft: 8 |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm9082446 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/jcm9082446 Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2077-0383/9/8/2446 
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| Verfasserangaben: | Mascha O. Fiedler, Dovile Diktanaite, Emilis Simeliunas, Maximilian Pilz and Armin Kalenka |
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| 245 | 1 | 0 | |a Prospective observational study to evaluate the effect of different levels of positive end-expiratory pressure on lung mechanics in patients with and without acute respiratory distress syndrome |c Mascha O. Fiedler, Dovile Diktanaite, Emilis Simeliunas, Maximilian Pilz and Armin Kalenka |
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| 520 | |a Background: The optimal level of positive end-expiratory pressure is still under debate. There are scare data examining the association of PEEP with transpulmonary pressure (TPP), end-expiratory lung volume (EELV) and intraabdominal pressure in ventilated patients with and without ARDS. Methods: We analyzed lung mechanics in 3 patient groups: group A, patients with ARDS; group B, obese patients (body mass index (BMI) > 30 kg/m2) and group C, a control group. Three levels of PEEP (5, 10, 15 cm H2O) were used to investigate the consequences for lung mechanics. Results: Fifty patients were included, 22 in group A, 18 in group B (BMI 38 ± 2 kg/m2) and 10 in group C. At baseline, oxygenation showed no differences between the groups. Driving pressure (ΔP) and transpulmonary pressure (ΔPL) was higher in group B than in groups A and C at a PEEP of 5 cm H2O (ΔP A: 15 ± 1, B: 18 ± 1, C: 14 ± 1 cm H2O; ΔPL A: 10 ± 1, B: 13 ± 1, C: 9 ± 0 cm H2O). Peak inspiratory pressure (Pinsp) rose in all groups as PEEP increased, but the resulting driving pressure and transpulmonary pressure were reduced, whereas EELV increased. Conclusion: Measuring EELV or TPP allows a personalized approach to lung-protective ventilation. | ||
| 650 | 4 | |a acute respiratory distress syndrome | |
| 650 | 4 | |a end-expiratory lung volume | |
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| 650 | 4 | |a mechanical ventilation | |
| 650 | 4 | |a positive end-expiratory pressure | |
| 650 | 4 | |a transpulmonary pressure | |
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