Open AccessTitration of ideal positive end-expiratory pressure in acute respiratory distress syndrome: Comparison between lower inflection point and esophageal pressure method using volumetric capnography
Author(s) -
Nandakishore Baikunje,
Inderpaul Singh Sehgal,
Sahajal Dhooria,
Kuruswamy Thurai Prasad,
Ritesh Agarwal
Publication year - 2017
Publication title -
indian journal of critical care medicine/indian journal of critical care medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 30
eISSN - 1998-359X
pISSN - 0972-5229
DOI - 10.4103/ijccm.ijccm_11_17
Subject(s) - medicine , ards , transpulmonary pressure , positive end expiratory pressure , dead space , plateau pressure , capnography , inflection point , mechanical ventilation , anesthesia , tidal volume , oxygenation , respiratory distress , respiratory physiology , pulmonary compliance , respiratory system , lung volumes , lung , mathematics , geometry
The tenets of mechanical ventilation in acute respiratory distress syndrome (ARDS) include the utilization of low tidal volume and optimal application of positive end-expiratory pressure (PEEP). Optimal PEEP in ARDS is characterized by reduction in alveolar dead space along with improvement in the lung compliance and resultant betterment in oxygenation. There are various methods of setting PEEP in ARDS. Herein, we report a patient of ARDS, wherein we employed measurement of dead space using volumetric capnography to compare two different PEEP strategies, namely, the lower inflection point and transpulmonary pressure monitoring.