Author: Bein, Thomas; Grasso, Salvatore; Moerer, Onnen; Quintel, Michael; Guerin, Claude; Deja, Maria; Brondani, Anita; Mehta, Sangeeta
Title: The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia Document date: 2016_4_4
ID: krpg9u1u_15
Snippet: Increasing inspiratory time has been suggested to improve oxygenation. The effect of a high I:E ratio in hypoxemic ARDS patients is related to the resultant increase in intrinsic PEEP (PEEPi), improved ventilation of units with long time constants, and alveolar recruitment secondary to increased mean airway pressure (M PAW ) [22] . The results regarding the effect of different I:E ratios are conflicting [22, 23] . Reported positive effects have b.....
Document: Increasing inspiratory time has been suggested to improve oxygenation. The effect of a high I:E ratio in hypoxemic ARDS patients is related to the resultant increase in intrinsic PEEP (PEEPi), improved ventilation of units with long time constants, and alveolar recruitment secondary to increased mean airway pressure (M PAW ) [22] . The results regarding the effect of different I:E ratios are conflicting [22, 23] . Reported positive effects have been ascribed to the shortening of expiratory time, increased M PAW and PEEPi [24] . Using extrinsic PEEP is perhaps the more physiological approach as it maintains a controlled and constant level. Moreover, the impact of an inconstant PEEPi on the "stress/strain × time product" for the pathogenesis of VALI calls for caution [25] .
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