Recruitment maneuvers and PEEP titration

Respiratory Care

Volumn 60, Issue 11, 2015, Pages 1688-1704

  Hess, Dean R ^a  

^a NORTHEASTERN UNIVERSITY   (United States)

Author keywords

ARDS; Mechanical ventilation; PEEP; Recruitment maneuver

Indexed keywords

ADULT RESPIRATORY DISTRESS SYNDROME; ARTICLE; ARTIFICIAL VENTILATION; HUMAN; LUNG VOLUME; MEDICAL PROCEDURES; POSITIVE END EXPIRATORY PRESSURE; RECRUITMENT MANEUVER; RESPIRATORY CARE; RESPIRATORY TRACT PARAMETERS; TREATMENT OUTCOME; BREATHING MECHANICS; LUNG ALVEOLUS; LUNG COMPLIANCE; LUNG GAS EXCHANGE; PATHOPHYSIOLOGY; PHYSIOLOGICAL STRESS; PRESSURE; PROCEDURES; RADIOGRAPHY; RESPIRATORY DISTRESS SYNDROME, ADULT; SEVERITY OF ILLNESS INDEX;

HUMANS; LUNG COMPLIANCE; POSITIVE-PRESSURE RESPIRATION; PRESSURE; PULMONARY ALVEOLI; PULMONARY GAS EXCHANGE; RESPIRATORY DISTRESS SYNDROME, ADULT; RESPIRATORY MECHANICS; SEVERITY OF ILLNESS INDEX; STRESS, PHYSIOLOGICAL;

EID: 84944716871     PISSN: 00201324     EISSN: 19433654     Source Type: Journal    
DOI: 10.4187/respcare.04409     Document Type: Article

References (106)

1. Gattinoni L, Pesenti A. The concept of “baby lung.” Intensive Care Med 2005;31(6):776-784.
2. Slutsky AS, Ranieri VM. Ventilator-induced lung injury. N Engl J Med 2014;370(10):980.
3. Hubmayr RD. Perspective on lung injury and recruitment: a skeptical look at the opening and collapse story. Am J Respir Crit Care Med 2002;165(12):1647-1653.
4. The Acute Respiratory Distress Syndrome Network. Ventilationn with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syn- drome. N Engl J Med 2000;342(18):1301-1308.
5. Needham DM, Colantuoni E, Mendez-Tellez PA, Dinglas VD, Sevransky JE, Dennison Himmelfarb CR, et al. Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study. BMJ 2012;344:e2124.
6. Needham DM, Yang T, Dinglas VD, Mendez-Tellez PA, Shanholtz C, Sevransky JE, et al. Timing of low tidal volume ventilation and intensive care unit mortality in acute respiratory distress syndrome. A prospective cohort study. Am J Respir Crit Care Med 2015; 191(2):177-185.
7. Terragni PP, Filippini C, Slutsky AS, Birocco A, Tenaglia T, Grasso S, et al. Accuracy of plateau pressure and stress index to identify injurious ventilation in patients with acute respiratory distress syn-drome. Anesthesiology 2013;119(4):880-889.
8. Terragni PP, Rosboch G, Tealdi A, Corno E, Menaldo E, Davini O, et al. Tidal hyperinflation during low tidal volume ventilation in acute respiratory distress syndrome. Am J Respir Crit Care Med 2007;175(2):160-166.
9. Serpa Neto A, Cardoso SO, Manetta JA, Pereira VG, Espósito DC, Pasqualucci Mde O, et al. Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta- analysis. JAMA 2012;308(16):1651-1659.
10. Hess DR. Approaches to conventional mechanical ventilation of the patient with acute respiratory distress syndrome. Respir Care 2011; 56(10):1555-1572.
11. Hess DR. Ventilatory strategies in severe acute respiratory failure. Semin Respir Crit Care Med 2014;35(4):418-430.
12. Ramnath VR, Hess DR, Thompson BT. Conventional mechanical ventilation in acute lung injury and acute respiratory distress syndrome. Clin Chest Med 2006;27(4):601-613; abstract viii.
13. Gattinoni L, Carlesso E, Caironi P. Stress and strain within the lung. Curr Opin Crit Care 2012;18(1):42-47.
14. Mead J, Takishima T, Leith D. Stress distribution in lungs: a model of pulmonary elasticity. J Appl Physiol 1970;28(5):596-608.
15. Gattinoni L, Caironi P, Cressoni M, Chiumello D, Ranieri VM, Quintel M, et al. Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med 2006;354(17):1775-1786.
16. Villar J, Pérez-Méndez L, López J, Belda J, Blanco J, Saralegui I, et al. An early PEEP/FIO2 trial identifies different degrees of lung injury in patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2007;176(8):795-804.
17. Chiumello D, Cressoni M, Carlesso E, Caspani ML, Marino A, Gallazzi E, et al. Bedside selection of positive end-expiratory pressure in mild, moderate, and severe acute respiratory distress syn-drome. Crit Care Med 2014;42(2):252-264.
18. Hess DR, Bigatello LM. Lung recruitment: the role of recruitment maneuvers. Respir Care 2002;47(3):308-317; discussion 317-318.
19. Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 1998;338(6):347-354.
20. Brower RG, Morris A, MacIntyre N, Matthay MA, Hayden D, Thompson T, et al. Effects of recruitment maneuvers in patients with acute lung injury and acute respiratory distress syndrome ven- tilated with high positive end-expiratory pressure. Crit Care Med 2003;31(11):2592-2597.
21. Meade MO, Cook DJ, Griffith LE, Hand LE, Lapinsky SE, Stewart TE, et al. A study of the physiologic responses to a lung recruitment maneuver in acute lung injury and acute respiratory distress syn- drome. Respir Care 2008;53(11):1441-1449.
22. Fan E, Checkley W, Stewart TE, Muscedere J, Lesur O, Granton JT, et al. Complications from recruitment maneuvers in patients with acute lung injury: secondary analysis from the lung open ven- tilation study. Respir Care 2012;57(11):1842-1849.
23. Arnal JM, Paquet J, Wysocki M, Demory D, Donati S, Granier I, et al. Optimal duration of a sustained inflation recruitment maneuver in ARDS patients. Intensive Care Med 2011;37(10):1588-1594.
24. Kacmarek RM, Villar J. Management of refractory hypoxemia in ARDS. Minerva Anestesiol 2013;79(10):1173-1179.
25. Borges JB, Okamoto VN, Matos GF, Caramez MP, Arantes PR, Barros F, et al. Reversibility of lung collapse and hypoxemia in early acute respiratory distress syndrome. Am J Respir Crit Care Med 2006;174(3):268-278.
26. Girgis K, Hamed H, Khater Y, Kacmarek RM. A decremental PEEP trial identifies the PEEP level that maintains oxygenation after lung recruitment. Respir Care 2006;51(10):1132-1139.
27. Toth I, Leiner T, Mikor A, Szakmany T, Bogar L, Molnar Z. Hemodynamic and respiratory changes during lung recruitment and descending optimal positive end-expiratory pressure titration in pa- tients with acute respiratory distress syndrome. Crit Care Med 2007; 35(3):787-793.
28. Fengmei G, Jin C, Songqiao L, Congshan Y, Yi Y. Dead space fraction changes during PEEP titration following lung recruitment in patients with ARDS. Respir Care 2012;57(10):1578-1585.
29. Marini JJ. Recruitment by sustained inflation: time for a change. Intensive Care Med 2011;37(10):1572-1574.
30. Froese AB, Bryan AC. Effects of anesthesia and paralysis on diaphragmatic mechanics in man. Anesthesiology 1974;41(3):242-255.
31. Maung AA, Schuster KM, Kaplan LJ, Ditillo MF, Piper GL, Maerz LL, et al. Compared to conventional ventilation, airway pressure release ventilation may increase ventilator days in trauma patients. J Trauma Acute Care Surg 2012;73(2):507-510.
32. Maxwell RA, Green JM, Waldrop J, Dart BW, Smith PW, Brooks D, et al. A randomized prospective trial of airway pressure release ventilation and low tidal volume ventilation in adult trauma patients with acute respiratory failure. J Trauma 2010;69(3):501-510; dis- cussion 511.
33. Varpula T, Valta P, Niemi R, Takkunen O, Hynynen M, Pettilä VV. Airway pressure release ventilation as a primary ventilatory mode in acute respiratory distress syndrome. Acta Anaesthesiol Scand 2004;48(6):722-731.
34. Richard JC, Lyazidi A, Akoumianaki E, Mortaza S, Cordioli RL, Lefebvre JC, et al. Potentially harmful effects of inspiratory synchronization during pressure preset ventilation. Intensive Care Med 2013;39(11):2003-2010.
35. Young D, Lamb SE, Shah S, MacKenzie I, Tunnicliffe W, Lall R, et al. High-frequency oscillation for acute respiratory distress syndrome. N Engl J Med 2013;368(9):806-813.
36. Ferguson ND, Cook DJ, Guyatt GH, Mehta S, Hand L, Austin P, et al. High-frequency oscillation in early acute respiratory distress syndrome. N Engl J Med 2013;368(9):795-805.
37. Huang CT, Lin HH, Ruan SY, Lee MS, Tsai YJ, Yu CJ. Efficacy and adverse events of high-frequency oscillatory ventilation in adultpatients with acute respiratory distress syndrome: a meta-analysis. Crit Care 2014;18(3):R102.
38. Foti G, Cereda M, Sparacino ME, De Marchi L, Villa F, Pesenti A. Effects of periodic lung recruitment maneuvers on gas exchange and respiratory mechanics in mechanically ventilated acute respi-ratory distress syndrome (ARDS) patients. Intensive Care Med 2000; 26(5):501-507.
39. Patroniti N, Foti G, Cortinovis B, Maggioni E, Bigatello LM, Cereda M, Pesenti A. Sigh improves gas exchange and lung volume in patients with acute respiratory distress syndrome undergoing pres- sure support ventilation. Anesthesiology 2002;96(4):788-794.
40. Pelosi P, Cadringher P, Bottino N, Panigada M, Carrieri F, Riva E, et al. Sigh in acute respiratory distress syndrome. Am J Respir Crit Care Med 1999;159(3):872-880.
41. Pelosi P, Chiumello D, Calvi E, Taccone P, Bottino N, Panigada M, et al. Effects of different continuous positive airway pressure de-vices and periodic hyperinflations on respiratory function. Crit Care Med 2001;29(9):1683-1689.
42. Mauri T, Eronia N, Abbruzzese C, Marcolin R, Coppadoro A, Spadaro S, et al. Effects of sigh on regional lung strain and ventilation heterogeneity in acute respiratory failure patients undergoing assisted mechanical ventilation. Crit Care Med 2015;43(9);1823-1831.
43. Gattinoni L, Taccone P, Carlesso E, Marini JJ. Prone position in acute respiratory distress syndrome. Rationale, indications, and limits. Am J Respir Crit Care Med 2013;188(11):1286-1293.
44. Guérin C. Prone position. Curr Opin Crit Care 2014;20(1):92-97.
45. Guerin C, Baboi L, Richard JC. Mechanisms of the effects of prone positioning in acute respiratory distress syndrome. Intensive Care Med 2014;40(11):1634-1642.
46. Mentzelopoulos SD, Roussos C, Zakynthinos SG. Prone position reduces lung stress and strain in severe acute respiratory distress syndrome. Eur Respir J 2005;25(3):534-544.
47. Guérin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 2013;368(23):2159-2168.
48. Beitler JR, Shaefi S, Montesi SB, Devlin A, Loring SH, Talmor D, Malhotra A. Prone positioning reduces mortality from acute respiratory distress syndrome in the low tidal volume era: a meta-analysis. Intensive Care Med 2014;40(3):332-341.
49. Lee JM, Bae W, Lee YJ, Cho YJ. The efficacy and safety of prone positional ventilation in acute respiratory distress syndrome: updated study-level meta-analysis of 11 randomized controlled trials. Crit Care Med 2014;42(5):1252-1262.
50. Villar J, Kacmarek RM, Pérez-Méndez L, Aguirre-Jaime A. A high positive end-expiratory pressure, low tidal volume ventilatory strategy improves outcome in persistent acute respiratory distress syndrome: a randomized, controlled trial. Crit Care Med 2006;34(5): 1311-1318.
51. Meade MO, Cook DJ, Guyatt GH, Slutsky AS, Arabi YM, Cooper DJ, et al. Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized con- trolled trial. JAMA 2008;299(6):637-645.
52. Hodgson CL, Tuxen DV, Davies AR, Bailey MJ, Higgins AM, Holland AE, et al. A randomised controlled trial of an open lung strategy with staircase recruitment, titrated PEEP and targeted low airway pressures in patients with acute respiratory distress syn- drome. Crit Care 2011;15(3):R133.
53. Suzumura EA, Figueiró M, Normilio-Silva K, Laranjeira L, Oliveira C, Buehler AM, et al. Effects of alveolar recruitment maneuvers on clinical outcomes in patients with acute respiratory distress syndrome: a systematic review and meta-analysis. Intensive Care Med 2014;40(9):1227-1240.
54. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet 1967;2(7511):319-323.
55. Downs JB, Klein EF Jr, Modell JH. The effect of incremental PEEP on PaO 2 in patients with respiratory failure. Anesth Analg 1973; 52(2):210-215.
56. Kirby RR, Downs JB, Civetta JM, Modell JH, Dannemiller FJ, Klein EF, Hodges M. High level positive end expiratory pressure (PEEP) in acute respiratory insufficiency. Chest 1975;67(2):156-163.
57. Ferguson ND, Frutos-Vivar F, Esteban A, Anzueto A, Alía I, Brower RG, et al. Airway pressures, tidal volumes, and mortality in patients with acute respiratory distress syndrome. Crit Care Med 2005;33(1): 21-30.
58. Goligher EC, Kavanagh BP, Rubenfeld GD, Adhikari NK, Pinto R, Fan E, et al. Oxygenation response to positive end-expiratory pressure predicts mortality in acute respiratory distress syndrome. A secondary analysis of the LOVS and ExPress trials. Am J Respir Crit Care Med 2014;190(1):70-76.
59. Brower RG, Lanken PN, MacIntyre N, Matthay MA, Morris A, Ancukiewicz M, et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med 2004;351(4):327-336.
60. Arnal JM, Garnero A, Novonti D, Demory D, Ducros L, Berric A, et al. Feasibility study on full closed-loop control ventilation (IntelliVent-ASV) in ICU patients with acute respiratory failure: a prospective observational comparative study. Crit Care 2013;17(5): R196.
61. Arnal JM, Wysocki M, Novotni D, Demory D, Lopez R, Donati S, et al. Safety and efficacy of a fully closed-loop control ventilation (IntelliVent-ASV) in sedated ICU patients with acute respiratory failure: a prospective randomized crossover study. Intensive Care Med 2012;38(5):781-787.
62. Clavieras N, Wysocki M, Coisel Y, Galia F, Conseil M, Chanques G, et al. Prospective randomized crossover study of a new closedloop control system versus pressure support during weaning from mechanical ventilation. Anesthesiology 2013;119(3):631-641.
63. Mercat A, Richard JC, Vielle B, Jaber S, Osman D, Diehl JL, et al. Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized con- trolled trial. JAMA 2008;299(6):646-655.
64. Grasso S, Stripoli T, De Michele M, Bruno F, Moschetta M, Angelelli G, et al. ARDSnet ventilatory protocol and alveolar hyperinflation: role of positive end-expiratory pressure. Am J Respir Crit Care Med 2007;176(8):761-767.
65. Talmor D, Sarge T, Malhotra A, O’Donnell CR, Ritz R, Lisbon A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med 2008;359(20):2095-2104.
66. Suter PM, Fairley B, Isenberg MD. Optimum end-expiratory airway pressure in patients with acute pulmonary failure. N Engl J Med 1975;292(6):284-289.
67. Murray IP, Modell JH, Gallagher TJ, Banner MJ. Titration of PEEby the arterial minus end-tidal carbon dioxide gradient. Chest 1984; 85(1):100-104.
68. Blanch L, Fernández R, Benito S, Mancebo J, Net A. Effect of PEEP on the arterial minus end-tidal carbon dioxide gradient. Chest 1987;92(3):451-454.
69. Jardin F, Genevray B, Pazin M, Margairaz A. Inability to titrate PEEP in patients with acute respiratory failure using end-tidal carbon dioxide measurements. Anesthesiology 1985;62(4):530-533.
70. Anderson CT, Breen PH. Carbon dioxide kinetics and capnography during critical care. Crit Care 2000;4(4):207-215.
71. Pintado MC, de Pablo R, Trascasa M, Milicua JM, Rogero S, Daguerre M, et al. Individualized PEEP setting in subjects with ARDS: a randomized controlled pilot study. Respir Care 2013; 58(9):1416-1423.
72. Amato MB, Meade MO, Slutsky AS, Brochard L, Costa EL, Schoenfeld DA, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015;372(8):747-755.
73. Albaiceta GM, Blanch L, Lucangelo U. Static pressure-volume curves of the respiratory system: were they just a passing fad? Curr Opin Crit Care 2008;14(1):80-86.
74. Harris R S. Pressure-volume curves of the respiratory system. Respir Care 50(1):78-98, 2005; discussion 98-79.
75. Blanch L, López-Aguilar J, Villagrá A. Bedside evaluation of pressure-volume curves in patients with acute respiratory distress syndrome. Curr Opin Crit Care 2007;13(3):332-337.
76. Harris RS, Hess DR, Venegas JG. An objective analysis of the pressure-volume curve in the acute respiratory distress syndrome. Am J Respir Crit Care Med 2000;161(2 Pt 1):432-439.
77. Owens RL, Hess DR, Malhotra A, Venegas JG, Harris RS. Effect of the chest wall on pressure-volume curve analysis of acute respi- ratory distress syndrome lungs. Crit Care Med 2008;36(11):2980-2985.
78. Hickling KG. The pressure-volume curve is greatly modified by recruitment: a mathematical model of ARDS lungs. Am J Respir Crit Care Med 1998;158(1):194-202.
79. Hess DR. Respiratory mechanics in mechanically ventilated patients. Respir Care 2014;59(11):1773-1794.
80. Huang Y, Yang Y, Chen Q, Liu S, Liu L, Pan C, et al. Pulmonary acute respiratory distress syndrome: positive end-expiratory pressure titration needs stress index. J Surg Res 2013;185(1):347-352.
81. Loring SH, O’Donnell CR, Behazin N, Malhotra A, Sarge T, Ritz R, et al. Esophageal pressures in acute lung injury: do they repre- sent artifact or useful information about transpulmonary pressure, chest wall mechanics, and lung stress? J Appl Physiol 2010;108(3): 515-522.
82. Talmor DS, Fessler HE. Are esophageal pressure measurements important in clinical decision-making in mechanically ventilated patients? Respir Care 2010;55(2):162-172; discussion 172-164.
83. Dellamonica J, Lerolle N, Sargentini C, Beduneau G, Di Marco F, Mercat A, et al. Accuracy and precision of end-expiratory lung- volume measurements by automated nitrogen washout/washin tech- nique in patients with acute respiratory distress syndrome. Crit Care 2011;15(6):R294.
84. Chiumello D, Cressoni M, Chierichetti M, Tallarini F, Botticelli M, Berto V, et al. Nitrogen washout/washin, helium dilution and computed tomography in the assessment of end expiratory lung volume. Crit Care 2008;12(6):R150.
85. Branson RD, Johannigman JA. Innovations in mechanical ventila 86. Bikker IG, van Bommel J, Reis Miranda D, Bakker J, Gommers D. End-expiratory lung volume during mechanical ventilation: a comparison with reference values and the effect of positive end-expi- ratory pressure in intensive care unit patients with different lung conditions. Crit Care 2008;12(6):R145.
86. Dellamonica J, Lerolle N, Sargentini C, Beduneau G, Di Marco F, Mercat A, et al. PEEP-induced changes in lung volume in acuterespiratory distress syndrome: two methods to estimate alveolar recruitment. Intensive Care Med 2011;37(10):1595-1604.
87. Chiumello D, Froio S, Bouhemad B, Camporota L, Coppola S. Clinical review: Lung imaging in acute respiratory distress syn- drome patients-an update. Crit Care 2013;17(6):243.
88. Chiumello D, Marino A, Brioni M, Menga F, Cigada I, Lazzerini M, et al. Visual anatomical lung CT scan assessment of lung re- cruitability. Intensive Care Med 2013;39(1):66-73.
89. Gattinoni L, Caironi P, Valenza F, Carlesso E. The role of CT-scan studies for the diagnosis and therapy of acute respiratory distress syndrome. Clin Chest Med 2006;27(4):559-570; abstract vii.
90. Rouby JJ, Puybasset L, Nieszkowska A, Lu Q. Acute respiratory distress syndrome: lessons from computed tomography of the whole lung. Crit Care Med 2003;31(4 Suppl):S285-S295.
91. Wallet F, Delannoy B, Haquin A, Debord S, Leray V, Bourdin G, et al. Evaluation of recruited lung volume at inspiratory plateau pressure with PEEP using bedside digital chest x-ray in patients with acute lung injury/ARDS. Respir Care 2013;58(3): 416-423.
92. Arbelot C, Ferrari F, Bouhemad B, Rouby JJ. Lung ultrasound in acute respiratory distress syndrome and acute lung injury. Curr Opin Crit Care 2008;14(1):70-74.
93. Bouhemad B, Brisson H, Le-Guen M, Arbelot C, Lu Q, Rouby JJ. Bedside ultrasound assessment of positive end-expiratory pressureinduced lung recruitment. Am J Respir Crit Care Med 2011;183(3): 341-347.
94. Bouhemad B, Mongodi S, Via G, Rouquette I. Ultrasound for “lung monitoring” of ventilated patients. Anesthesiology 2015;122(2): 437-447.
95. Bouhemad B, Zhang M, Lu Q, Rouby JJ. Clinical review: Bedside lung ultrasound in critical care practice. Crit Care 2007;11(1):205.
96. Gardelli G, Feletti F, Nanni A, Mughetti M, Piraccini A, Zompatori M. Chest ultrasonography in the ICU. Respir Care 2012;57(5):773-781.
97. Costa EL, Lima RG, Amato MB. Electrical impedance tomography. Curr Opin Crit Care 2009;15(1):18-24.
98. Costa EL, Borges JB, Melo A, Suarez-Sipmann F, Toufen C Jr, Bohm SH, Amato MB. Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography. Intensive Care Med 2009;35(6):1132-1137.
99. Bikker IG, Leonhardt S, Bakker J, Gommers D. Lung volume calculated from electrical impedance tomography in ICU patients at different PEEP levels. Intensive Care Med 2009;35(8):1362-1367.
100. Bikker IG, Leonhardt S, Reis Miranda D, Bakker J, Gommers D. Bedside measurement of changes in lung impedance to monitor alveolar ventilation in dependent and non-dependent parts by elec- trical impedance tomography during a positive end-expiratory pres- sure trial in mechanically ventilated intensive care unit patients. Crit Care 2010;14(3):R100.
101. Bikker IG, Preis C, Egal M, Bakker J, Gommers D. Electrical impedance tomography measured at two thoracic levels can visualize the ventilation distribution changes at the bedside during a decremental positive end-expiratory lung pressure trial. Crit Care 2011;15(4):R193.
102. Zhao Z, Steinmann D, Frerichs I, Guttmann J, Moller K. PEEP titration guided by ventilation homogeneity: a feasibility study using electrical impedance tomography. Crit Care 2010;14(1):R8.
103. Chiumello D, Coppola S, Froio S, Mietto C, Brazzi L, Carlesso E, Gattinoni L. Time to reach a new steady state after changes of positive end expiratory pressure. Intensive Care Med 2013;39(8): 1377-1385.
104. Brower RG. Time to reach a new equilibrium after changes in PEEP in acute respiratory distress syndrome patients. Intensive Care Med 2013;39(11):2053-2055.
105. Briel M, Meade M, Mercat A, Brower RG, Talmor D, Walter SD, et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 2010;303(9):865-873.
106. Gattinoni L, Carlesso E, Cressoni M. Selecting the “right” positive end-expiratory pressure level. Curr Opin Crit Care 2015;21(1):50-57.