Outcome issues of mechanical ventilator settings in acute respiratory distress syndrome patients from Québec ICUs after the 2000 Acute Respiratory Distress Syndrome Network trial

2008 ◽  
Vol 4 (1) ◽  
pp. 15-21
Author(s):  
Yannick Poulin ◽  
Marc-Andre Leclair ◽  
Francois Lauzier ◽  
Yves Berthiaume ◽  
Yoanna Skrobik ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Mechanical Ventilator ◽  
Ventilator Settings

scholarly journals Use of Transpulmonary Pressure Monitoring in the Management of Extrapulmonary Pediatric Acute Respiratory Distress Syndrome With multi organ dysfunction syndrome (MODS): Are We Peepophobic?

2019 ◽  
Vol 12 ◽  
pp. 117954761984218 ◽  
Author(s):  
Mukul Pandey ◽  
Dhiren Gupta ◽  
Neeraj Gupta ◽  
Anil Sachdev
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Transpulmonary Pressure ◽  
Esophageal Pressure ◽  
Positive End Expiratory Pressure ◽  
Pressure Monitoring ◽  
Ventilator Settings ◽  
The Ideal

Manipulation of positive end-expiratory pressure (PEEP) has been shown to improve the outcome in pediatric acute respiratory distress syndrome (PARDS), but the “ideal” PEEP, in which the compliance and oxygenation are maximized, while overdistension and undesirable hemodynamic effects are minimized, is yet to be determined. Also, for a given level of PEEP, transpulmonary pressure (TPP) may vary unpredictably from patient to patient. Patients with high pleural pressure who are on conventional ventilator settings under inflation may cause hypoxemia. In such patients, raising PEEP to maintain a positive TPP might improve aeration and oxygenation without causing overdistension. We report a case of PARDS, who was managed using real-time esophageal pressure monitoring using the AVEA ventilator and thereby adjusting PEEP to maintain the positive TPP.

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