Standardized Use of Recruitment Maneuvers Leads to Higher Mortality in Acute Respiratory Distress Syndrome Patients

Positive end-expiratory pressure titration using respiratory system compliance after recruitment maneuvers harmed patients.

To mitigate ventilator-induced lung injury, finding the “right” level of positive end-expiratory pressure (PEEP) for a patient with acute respiratory distress syndrome (ARDS) is important. Identifying optimal PEEP remains challenging: Strategies include titration with pressure–volume curves, using esophageal balloons, (NEJM JW Emerg Med Dec 2008 and N Engl J Med 2008; 359:2095), and empirical trials. No approach has proven to be superior.

Investigators randomized 1010 patients with moderate-to-severe ARDS either to standard PEEP, based on the PEEP protocol from the ARDSnet trial group or to lung recruitment with PEEP set by respiratory-system compliance. The latter approach included administration of neuromuscular blockade followed by a recr…

Reviewing Author

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Standardized Use of Recruitment Maneuvers Leads to Higher Mortality in Acute Respiratory Distress Syndrome Patients

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Reviewing Author