PEEP in Patients With Acute Respiratory Failure

Condition(s) studied

Investigational drug(s) / intervention(s)

Mechanical ventilation: Optimum PEEP

Study summary

Positive end-expiratory pressure (PEEP) has become an essential component of the care of critically ill patients who require ventilatory support. In 1975, several investigators published the effects of PEEP in 15 mechanically ventilated patients with acute respiratory failure (ARF) supported by mechanical ventilation. FiO2 ranged between 21% to 75% and the tidal volume between 13 to 15 mL/kg. PEEP was increased in 3 cmH2O steps until cardiac output fell. The aim was to identify the "optimum" PEEP level. "Best" PEEP was associated simultaneously with the best static compliance of the respiratory system, the greatest oxygen transport, and the lowest dead space fraction. That study established the basis for the use of PEEP in patients with ARF worldwide. Although currently patients with ARF are ventilated with much lower tidal volumes, that study has never been validated. It is unknow whether their findings are currently valid, generalizable, and reproducible.

Eligibility

Primary outcome measure(s)

• static compliance of the respiratory system — at study enrollment
  ratio of tidal volume to pressure gradiente of the respiratory system
• oxygen transport — at study enrollment
  Cardiac output multiply by oxygen content in arterial blood
• dead space fraction — at study enrollment
  ratio of dead space to tidal volume

Trial sites (3)

More Jesus Villar trials in Spain

Other trials for the same condition