Treatment of the acute respiratory distress syndrome (ARDS)with positive end-expiratory pressure (PEEP) was introducedmore than 40 years ago.1,2 Few practitioners question the effectsof PEEP on hemoglobin saturation, but the optimal dose titrationis controversial. Usually PEEP is simply adjusted to a suitableincrease in oxygenation efficiency (i.e., the ratio of the partialpressure of arterial oxygen [PaO2] to the fraction of inspiredoxygen [FiO2]) or according to an algorithm such as the AcuteRespiratory Distress Syndrome Network (ARDSNet) protocol.3 BecausePEEP can impair cardiac output, some clinicians advocate titrationto maximal oxygen delivery, a method . . . [Full Text of this Article]
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This article (10.1056/NEJMe0806637) was published at www.nejm.org on November 11, 2008.
From the Department of Medicine, Vanderbilt University School of Medicine, Nashville.
This article has been cited by other articles:
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