| Autor: |
Heines SJH; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands. s.heines@mumc.nl., Strauch U; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands., van de Poll MCG; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.; Department of Surgery, Maastricht University Medical Centre+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.; School of Nutrition and Translational Research in Medicine (NUTRIM), Maastricht University, P.O. Box 616, 6200MD, Maastricht, The Netherlands., Roekaerts PMHJ; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, P.O. Box 616, 6200MD, Maastricht, The Netherlands., Bergmans DCJJ; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands. |
| Abstrakt: |
To report on our clinical experience using EIT in individualized PEEP titration in ARDS. Using EIT assessment, we optimized PEEP settings in 39 ARDS patients. The EIT PEEP settings were compared with the physicians' PEEP settings and the PEEP settings according to the ARDS network. We defined a PEEP difference equal to or greater than 4 cm H 2 O as clinically relevant. Changes in lung compliance and PaO 2 /FiO 2 -ratio were compared in patients with EIT-based PEEP adjustments and in patients with unaltered PEEP. In 28% of the patients, the difference in EIT-based PEEP and physician-PEEP was clinically relevant; in 36%, EIT-based PEEP and physician-PEEP were equal. The EIT-based PEEP disagreed with the PEEP settings according to the ARDS network. Adjusting PEEP based upon EIT led to a rapid increase in lung compliance and PaO 2 /FiO 2 -ratio. However, this increase was also observed in the group where the PEEP difference was less than 4 cm H 2 O. We hypothesize that this can be attributed to the alveolar recruitment during the PEEP trial. EIT based individual PEEP setting appears to be a promising method to optimize PEEP in ARDS patients. The clinical impact, however, remains to be established. |
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