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Published at www.nejm.org November 11, 2008 (10.1056/NEJMe0806637)

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Treatment of the acute respiratory distress syndrome (ARDS) with positive end-expiratory pressure (PEEP) was introduced more than 40 years ago.^1,2 Few practitioners question the effects of PEEP on hemoglobin saturation, but the optimal dose titration is controversial. Usually PEEP is simply adjusted to a suitable increase in oxygenation efficiency (i.e., the ratio of the partial pressure of arterial oxygen [PaO₂] to the fraction of inspired oxygen [FIO₂]) or according to an algorithm such as the Acute Respiratory Distress Syndrome Network (ARDSNet) protocol.³ Because PEEP can impair cardiac output, some clinicians advocate titration to maximal oxygen delivery, a method . . . [Full Text of this Article]

Source Information

From the Department of Medicine, Vanderbilt University School of Medicine, Nashville.

This article (10.1056/NEJMe0806637) was published at www.nejm.org on November 11, 2008. It will appear in the November 13 issue of the Journal.

This article has been cited by other articles:

• (2008). Finding the Optimal PEEP for Patients with ARDS. JWatch Emergency Med. 2008: 2-2 [Full Text]