Large inspiratory tidal volume, rather than high peak airway pressure (Ppeak), may be responsible for ventilator-associated lung injury in patients with acute respiratory distress syndrome (ARDS). Sustained increases in Ppeak are, however, a nonspecific marker of airway complications and should be investigated. Plateau pressure (Pplat) is useful as an approximation of alveolar pressure; it should not exceed 35 cm H2O. Limiting Pplat by using smaller tidal volumes appears to mitigate the potential for lung injury and may reduce ARDS-related mortality. Intrinsic positive end-expiratory pressure (PEEP) can cause hemodynamic compromise; to detect it, an end-expiratory hold maneuver is performed. Applying external PEEP according to the location of the lower inflection point of the pressure-volume curve may improve oxygenation while helping to avoid barotrauma.
|Original language||English (US)|
|Number of pages||11|
|Journal||Journal of Critical Illness|
|State||Published - Jan 1 2000|
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine