Higher positive end-expiratory pressure no benefit in ARDS

Higher positive end-expiratory pressure no benefit in ARDS

(HealthDay)—For patients with acute respiratory distress syndrome (ARDS), higher positive end-expiratory pressure (PEEP) levels are not likely to improve clinical outcomes, according to a review published in the October issue of the Annals of the American Thoracic Society.

Allan J. Walkey, M.D., from Boston University School of Medicine, and colleagues conducted a systematic review of clinical trials to compare of mechanical ventilation strategies using higher PEEP levels versus lower PEEP levels in with ARDS. Eight randomized trials, with 2,728 patients with ARDS, that compared higher versus lower PEEP strategies were included in the analysis.

The researchers found that the mean PEEP was 15.1±3.6 cm H2O versus 9.1±2.7 cm H2O in the higher and lower PEEP groups, respectively. In the primary analysis that excluded two trials that did not use lower tidal volume ventilation in the lower PEEP control groups, mortality was not significantly reduced for patients receiving higher versus lower PEEP (relative risk [RR], 0.91; 95 percent confidence interval, 0.8 to 1.03). There was also no significant decrease in barotrauma, new organ failure, or ventilator-free days for a higher versus a lower PEEP strategy. A significant mortality reduction for high PEEP was seen in secondary analysis that included all eight trials (RR, 0.84; 95 percent confidence interval, 0.71 to 0.99).

"Use of higher PEEP is unlikely to improve clinical outcomes among unselected patients with ARDS," the authors write.


Explore further

Optimal mechanical ventilation strategy identified for obese

More information: Abstract
Full Text

Copyright © 2017 HealthDay. All rights reserved.

Citation: Higher positive end-expiratory pressure no benefit in ARDS (2017, November 19) retrieved 6 December 2021 from https://medicalxpress.com/news/2017-11-higher-positive-end-expiratory-pressure-benefit.html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.
9 shares

Feedback to editors