In the article, “Compressive Forces and Computed Topography-derived Positive End-expiratory Pressure in Acute Respiratory Distress Syndrome” (Cressoni et al. 2014), the researchers' hypothesis was that there was a direct correlation between lung recruitability and positive end-expiratory pressure (PEEP). This would validate the prevailing notion that higher PEEP is only for patients with higher lung recruitability. Previous studies have led to advancements in the field such as the switch from optimal gas exchange to lung protection (Lachmann 1994) and that the optimum PEEP level should avoid lung damage through intratidal opening and closing (Carioni et al. 2010). The study was influenced by previous findings (Phoenix et al. 2009) (Chiumello et al. 2014) that a higher PEEP might be more advantageous for patients with higher lung recruitability.
Method …show more content…
Of the patients studied, seven had mild ARDS, thirty had moderate ARDS, and eleven had severe ARDS. Lung recruitability was measured as the amount of functional lung tissue that re-inflated at or before 45 centimeters of water pressure. The lung recruitability of the patients varied from as low as three percent to a high as fifty percent. CT derived PEEP was computed as the sum of the pleural pressure required to lift the chest wall and the transpulmonary pressure needed to overcome the maximal superimposed pressure. Maximal superimposed pressure was computed by diving each patient's lungs into twenty sections, multiplying the suction height by the suction density and selecting the highest value. Linear regression, specifically the Wilcoxon test and two-way ANOVA, was used to analyze the relationship between lung recruitability, maximal superimposed pressure and
Method …show more content…
Of the patients studied, seven had mild ARDS, thirty had moderate ARDS, and eleven had severe ARDS. Lung recruitability was measured as the amount of functional lung tissue that re-inflated at or before 45 centimeters of water pressure. The lung recruitability of the patients varied from as low as three percent to a high as fifty percent. CT derived PEEP was computed as the sum of the pleural pressure required to lift the chest wall and the transpulmonary pressure needed to overcome the maximal superimposed pressure. Maximal superimposed pressure was computed by diving each patient's lungs into twenty sections, multiplying the suction height by the suction density and selecting the highest value. Linear regression, specifically the Wilcoxon test and two-way ANOVA, was used to analyze the relationship between lung recruitability, maximal superimposed pressure and