Hemodynamic And End-Organ Effects Of High Peep Strategy Titrated To Transpulmonary Pressure Academic Article uri icon

abstract

  • CONCLUSIONS: Individualizing PEEP to optimize transpulmonary pressures estimated from esophageal manometry resulted in no detectable difference in hemodynamics, or organ function as measured by SOFA scores, fluid balance or vasopressor requirements. This technique has been shown to improve oxygenation and compliance and may allow clinicians to balance the competing goals of minimizing atelectasis and preventing tidal hyper-inflation. We hypothesize that recruitment of atelectatic lung by higher levels of PEEP may reduce pulmonary vascular resistance and explain differences from previous studies. Echocardiographic studies of the cardiac effects of PEEP titrated by esophageal pressure are ongoing.

publication date

  • May 1, 2012