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Copyright © 2004 Massachusetts Medical Society. All rights reserved. Volume 351(4), 22 July 2004, pp 327-336
Higher versus Lower PositiveEnd-Expiratory Pressures in Patients with the Acute Respiratory Distress Syndrome
[Original Articles]
The National Heart, Lung, and Blood Institute ARDS Clinical Trials Network*
The members of the WritingCommittee (Roy G. Brower, M.D., Johns Hopkins University, Baltimore; Paul N. Lanken, M.D., University of Pennsylvania, Philadelphia; Neil MacIntyre, M.D., Duke University, Durham, N.C.; Michael A.Matthay, M.D., University of California, San Francisco, San Francisco; Alan Morris, M.D., LDS Hospital, Salt Lake City; and Marek Ancukiewicz, Ph.D., David Schoenfeld, Ph.D., and B. Taylor Thompson, M.D.,Massachusetts General Hospital, Boston) of the National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network assume responsibility for the integrity ofthe article. Address reprint requests to Dr. Brower at Johns Hopkins University, 1830 East Monument St., Rm. participating institutions are listed in the Appendix.
Abstract
Background: Most patientsrequiring mechanical ventilation for acute lung injury and the acute respiratory distress syndrome (ARDS) receive positive end-expiratory pressure (PEEP) of 5 to 12 cm of water. Higher PEEP levels mayimprove oxygenation and reduce ventilator-induced lung injury but may also cause circulatory depression and lung injury from overdistention. We conducted this trial to compare the effects of higher...