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Critical Care
Published in: Critical Care 2/2010

01-04-2010 | Commentary

Can heterogeneity in ventilation be good?

Authors: Eduardo LV Costa, Marcelo BP Amato

Published in: Critical Care | Issue 2/2010

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Abstract

Selection of the optimal positive end-expiratory pressure (PEEP) to avoid ventilator-induced lung injury in patients under mechanical ventilation is still a matter of debate. Many methods are available, but none is considered the gold standard. In the previous issue of Critical Care, Zhao and colleagues applied a method based on electrical impedance tomography to help select the PEEP that minimized ventilation inhomogeneities. Though promising when alveolar collapse and overdistension are present, this method might be misleading in patients with normal lungs.
Literature
1.
Zhao Z, Steinmann D, Frerichs I, Guttmann J, Möller K: PEEP titration guided by ventilation homogeneity: a feasibility study using electrical impedance tomography. Crit Care 2010, 14: R8. 10.1186/cc8860PubMedCentralCrossRefPubMed
2.
Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, Kairalla RA, Deheinzelin D, Munoz C, Oliveira R, Takagaki TY, Carvalho CR: Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 1998, 338: 347-354. 10.1056/NEJM199802053380602CrossRefPubMed
3.
Suarez-Sipmann F, Böhm SH, Tusman G, Pesch T, Thamm O, Reissmann H, Reske A, Magnusson A, Hedenstierna G: Use of dynamic compliance for open lung positive end-expiratory pressure titration in an experimental study. Crit Care Med 2007, 35: 214-221. 10.1097/01.CCM.0000251131.40301.E2CrossRefPubMed
4.
Hedenstierna G, Tokics L, Strandberg A, Lundquist H, Brismar B: Correlation of gas exchange impairment to development of atelectasis during anaesthesia and muscle paralysis. Acta Anaesthesiol Scand 1986, 30: 183-191. 10.1111/j.1399-6576.1986.tb02393.xCrossRefPubMed
5.
Borges JB, Okamoto VN, Matos GF, Caramez MP, Arantes PR, Barros F, Souza CE, Victorino JA, Kacmarek RM, Barbas CS, Carvalho CR, Amato MB: Reversibility of lung collapse and hypoxemia in early acute respiratory distress syndrome. Am J Respir Crit Care Med 2006, 174: 268-278. 10.1164/rccm.200506-976OCCrossRefPubMed
6.
Costa EL, Borges JB, Melo A, Suarez-Sipmann F, Toufen C Jr, Bohm SH, Amato MB: Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography. Intensive Care Med 2009, 35: 1132-1137. 10.1007/s00134-009-1447-yCrossRefPubMed
7.
Meier T, Luepschen H, Karsten J, Leibecke T, Grossherr M, Gehring H, Leonhardt S: Assessment of regional lung recruitment and derecruitment during a PEEP trial based on electrical impedance tomography. Intensive Care Med 2008, 34: 543-550. 10.1007/s00134-007-0786-9CrossRefPubMed
8.
Terragni PP, Rosboch G, Tealdi A, Corno E, Menaldo E, Davini O, Gandini G, Herrmann P, Mascia L, Quintel M, Slutsky AS, Gattinoni L, Ranieri VM: Tidal hyperinflation during low tidal volume ventilation in acute respiratory distress syndrome. Am J Respir Crit Care Med 2007, 175: 160-166. 10.1164/rccm.200607-915OCCrossRefPubMed
9.
Vawter DL, Matthews FL, West JB: Effect of shape and size of lung and chest wall on stresses in the lung. J Appl Physiol 1975, 39: 9-17.PubMed
10.
West JB, Matthews FL: Stresses, strains, and surface pressures in the lung caused by its weight. J Appl Physiol 1972, 32: 332-345.PubMed
11.
Hickling KG: Best compliance during a decremental, but not incremental, positive end-expiratory pressure trial is related to open-lung positive end-expiratory pressure: a mathematical model of acute respiratory distress syndrome lungs. Am J Respir Crit Care Med 2001, 163: 69-78.CrossRefPubMed
12.
Zhao Z, Möller K, Steinmann D, Frerichs I, Guttmann J: Evaluation of an electrical impedance tomography-based Global Inhomogeneity Index for pulmonary ventilation distribution. Intensive Care Med 2009, 35: 1900-1906. 10.1007/s00134-009-1589-yCrossRefPubMed
Metadata
Title
Can heterogeneity in ventilation be good?
Authors
Eduardo LV Costa
Marcelo BP Amato
Publication date
01-04-2010
Publisher
BioMed Central
Published in
Critical Care / Issue 2/2010
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc8901

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