What is the evidence for an open-lung strategy in ARDS?

RCT: ALVEOLIARDSNetNEJM (2004)View Paper RCT: LOVSMeade et alJAMA (2008)View Paper RCT: EXPRESSMercat et alJAMA (2008)View Paper RCTKacmarek et alCrit Care Med (2016)View Paper RCT: ARTCalvacanti et al et alJAMA (2017)View Paper Meta-AnalysisLu et alShock (2017)View...

How can you perform recruitment manoeuvres?

Method Prolonged Continuous Positive Pressure Staircase Manoeuvre Use of ‘Sighs’ Steps Period of continuous high pressure via the ventilatorExample: 40cm H20 for 40 seconds often used Stepped increase in PEEP with the maintenance of normal driving...

What is the best way to set the PEEP in ARDS?

Ultimately, despite much research, the best method to set PEEP in patients with ARDS remains uncertain Several approaches have been suggested each with their own merits and problems: Method Adjust according to FiO2 Lower Inflection point Maximal Static Compliance CT...

What is an open lung strategy of ventilation?

The ‘Open Lung’ ventilation strategy aims to optimize effective lung volume by recruiting and stabilizing unstable lung units and by ventilating by the principles of lung-protective ventilation It includes the use of: High PEEP Recruitment manoeuvres Aims to reduce...

What is the plateau pressure, and how should this be calculated?

Plateau pressure represents the pressure required to expand the lungs to a set volume in the absence of flow: Reflects the pressure to overcome pulmonary compliance This is different from the peak airway pressure, which describes the pressure to expand the lungs...