Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Recruit the lung before titrating the right positive end-expiratory pressure to protect it. | Available online http content 13 3 134 Commentary Recruit the lung before titrating the right positive end-expiratory pressure to protect it Fernando Suarez-Sipmann1 and Stephan H Bohm2 1 Department of Intensive Care Medicine Fundacion Jimenez Díaz-UTE Avda de los Reyes Católicos 2 28040 Madrid Spain 2Research Centre for Nanomedicine CSEM Centre Suisse d Electronique et de Microtechnique SA Schulstrasse 1 7302 Landquart Switzerland Corresponding author Fernando Suarez-Sipmann fsuarez@ Published 6 May 2009 This article is online at http content 13 3 134 2009 BioMed Central Ltd Critical Care 2009 13 134 doi cc7763 See related research by Huh et al. http content 13 1 R22 Abstract The optimal level of positive end-expiratory pressure PEEP in acute respiratory distress syndrome patients is still controversial and has gained renewed interest in the era of lung protective ventilation strategies . Despite experimental evidence that higher levels of PEEP protect against ventilator-induced lung injury recent clinical trials have failed to demonstrate clear survival benefits. The open-lung protective ventilation strategy combines lung recruitment maneuvers with a decremental PEEP trial aimed at finding the minimum level of PEEP that prevents the lung from collapsing. This approach to PEEP titration is more likely to exert its protective effects and is clearly different from the one used in previous clinical trials. In a previous issue of Critical Care the study presented by Huh and colleagues 1 illustrates both the difficulties in applying an open-lung strategy in the clinical setting and the importance of systematically assessing the effects of recruitment and positive end-expiratory pressure PEEP . The openlung concept was first described by Lachmann 2 almost two decades ago and later became an integral part of the protective ventilation strategy proposed by Amato and colleagues 3 . It is based on the sequential application
