Effects of end-expiratory lung volume versus PaO2 guided PEEP determination on respiratory mechanics and oxygenation in moderate to severe ARDS

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dc.authoridHanci, Pervin/0000-0002-7207-2041
dc.contributor.authorRollas, Kazim
dc.contributor.authorHanci, Pervin
dc.contributor.authorTopeli, Arzu
dc.date.accessioned2024-06-12T10:50:37Z
dc.date.available2024-06-12T10:50:37Z
dc.date.issued2022
dc.departmentTrakya Üniversitesien_US
dc.description.abstractBackground: There is no ideal method for determination of positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS) patients. We compared the effects of end-expiratory lung volume (EELV)-guided versus PaO2-guided PEEP determination on respiratory mechanics and oxygenation during the first 48 hours in moderate to severe ARDS. Methods: Twenty-two patients with moderate to severe ARDS admitted to an academic medical ICU were assigned to PaO2-guided (n = 11) or to EELV-guided PEEP determination (n = 11) group. First, an incremental PEEP trial was performed by increasing PEEP by 3 cmH(2)O steps from 8 to 20 cmH(2)O and in each step EELV and lung mechanics were measured in both groups. Then, oxygenation and respiratory mechanics were measured under the determined PEEP at 4, 12, 24, and 48th hours. Results: After the incremental PEEP trial, over the 48 hours of the study period, in the EELV-guided group PaO2 and PaO2/FiO(2) increased (p = 0.04 and p = 0.02; respectively), whereas they did not change in PaO2-guided group (p = 0.09 and p = 0.27; respectively). In all patients, the median value of EELV change (Delta EELV) during incremental PEEP trial was 25%. In patients with Delta EELV > 25% (n = 11) PaO2, PaO2/FiO(2) and Cs increased over time in 48 hours (p = 0.03, p < 0.01, and p = 0.04; respectively), whereas they did not change in those with Delta EELV <= 25% (n = 11) (p = 0.73, p = 0.51, and p = 0.73; respectively). Conclusion: Compared to PaO2-guided PEEP determination, EELV-guided PEEP determination resulted in greater improvement in oxygenation over time. Patients who had > 25% improvement in EELV during a PEEP trial had greater improvement in oxygenation and compliance over 48 hours. Supplemental data for this article is available online aten_US
dc.description.sponsorshipcoordination unit for scientific research projects, Hacettepe University [17388665-1639]en_US
dc.description.sponsorshipSupported by coordination unit for scientific research projects, Hacettepe University (Date: 14.05.2014; No: 17388665-1639). We thank to Franco Laghi, MD for his critical review.en_US
dc.identifier.doi10.1080/01902148.2021.2021326
dc.identifier.endpage22en_US
dc.identifier.issn0190-2148
dc.identifier.issn1521-0499
dc.identifier.issue1en_US
dc.identifier.pmid34957895en_US
dc.identifier.scopus2-s2.0-85121824833en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage12en_US
dc.identifier.urihttps://doi.org/10.1080/01902148.2021.2021326
dc.identifier.urihttps://hdl.handle.net/20.500.14551/18072
dc.identifier.volume48en_US
dc.identifier.wosWOS:000734821600001en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherTaylor & Francis Incen_US
dc.relation.ispartofExperimental Lung Researchen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAcute Respiratory Failureen_US
dc.subjectFunctional Residual Capacityen_US
dc.subjectGas Exchangeen_US
dc.subjectMechanical Ventilationen_US
dc.subjectOxygenationen_US
dc.subjectFunctional Residual Capacityen_US
dc.subjectDistress-Syndromeen_US
dc.subjectComputed-Tomographyen_US
dc.subjectAirway Pressureen_US
dc.subjectRecruitmenten_US
dc.subjectVentilationen_US
dc.subjectCurvesen_US
dc.subjectStrainen_US
dc.subjectInjuryen_US
dc.titleEffects of end-expiratory lung volume versus PaO2 guided PEEP determination on respiratory mechanics and oxygenation in moderate to severe ARDSen_US
dc.typeArticleen_US

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