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Ventilation Strategies for Acute Lung Injury and Acute Respiratory Distress Syndrome—Reply

Luciano Gattinoni, MD, FRCP; Pietro Caironi, MD
JAMA. 2008;300(1):39-43. doi:10.1001/jama.300.1.42-b.
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In Reply: Dr Oba proposes an approach to setting PEEP during ALI/ARDS based on the following conceptual model: by applying higher levels of PEEP the lung will be recruited and, with the tidal volume distributed across a greater portion of lung parenchyma, the plateau pressure will decrease; ie, the compliance of the respiratory system will increase. After the recruitment, a further increase of PEEP would lead to alveolar overdistention, and the compliance of the respiratory system would decrease accordingly. Indeed, the “best PEEP” would coincide with the “best compliance.”

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References

July 2, 2008
Jack J. Haitsma, MD, PhD; Paolo Pelosi, MD
JAMA. 2008;300(1):39-43. doi:10.1001/jama.300.1.39-a.
July 2, 2008
Yuji Oba, MD
JAMA. 2008;300(1):39-43. doi:10.1001/jama.300.1.39-b.
July 2, 2008
Jigeeshu Divatia, MD; Priya Ranganathan, MD
JAMA. 2008;300(1):39-43. doi:10.1001/jama.300.1.40-a.
July 2, 2008
L. M. A. Heunks, MD, PhD; J. G. van der Hoeven, MD, PhD
JAMA. 2008;300(1):39-43. doi:10.1001/jama.300.1.40-b.
July 2, 2008
João Batista Borges, MD; Carlos Roberto Ribeiro Carvalho, MD; Marcelo Britto Passos Amato, MD
JAMA. 2008;300(1):39-43. doi:10.1001/jama.300.1.41-a.
July 2, 2008
Maureen O. Meade, MD, MSc; Thomas E. Stewart, MD
JAMA. 2008;300(1):39-43. doi:10.1001/jama.300.1.42-a.
July 2, 2008
Alain Mercat, MD; Jean-Christophe Richard, MD; Laurent Brochard, MD
JAMA. 2008;300(1):39-43. doi:10.1001/jama.300.1.41-b.
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