Abstract | PURPOSE OF REVIEW: RECENT FINDINGS: Experimental and clinical data indicate that vigorous spontaneous effort may worsen lung injury, whereas, at the same time, the intensity of spontaneous effort seems difficult to control when lung injury is severe. Experimental studies found that higher PEEP strategy can be effective to reduce lung injury from spontaneous effort while maintaining some muscle activity. The recent clinical trial to reevaluate systemic early neuromuscular blockade in moderate-severe ARDS (i.e., reevaluation of systemic early neuromuscular blockade (ROSE) trial) support that a higher PEEP strategy can facilitate 'safe' spontaneous breathing under the light sedation targets (i.e., no increase in barotrauma nor 90 days mortality versus early muscle paralysis). SUMMARY: To prevent P-SILI in ARDS, it seems feasible to facilitate 'safe' spontaneous breathing in patients using a higher PEEP strategy in severe ARDS.
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Authors | Takeshi Yoshida, Domenico L Grieco, Laurent Brochard, Yuji Fujino |
Journal | Current opinion in critical care
(Curr Opin Crit Care)
Vol. 26
Issue 1
Pg. 59-65
(02 2020)
ISSN: 1531-7072 [Electronic] United States |
PMID | 31815775
(Publication Type: Journal Article, Review)
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Topics |
- Humans
- Lung
- Lung Injury
- Positive-Pressure Respiration
- Respiration, Artificial
(adverse effects)
- Respiratory Distress Syndrome
(therapy)
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