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Changes in shunt, ventilation/perfusion mismatch, and lung aeration with PEEP in patients with ARDS: A prospective single-arm interventional study

Critical Care Mar 30, 2020

Karbing DS, et al. - Researchers undertook this preliminary analysis to examine the link between alterations in shunt, low and high ventilation/perfusion (V/Q) mismatch, and computed tomography-measured lung aeration after a rise in positive end-expiratory pressure (PEEP) among patients with acute respiratory distress syndrome (ARDS). Overall 12 patients were subjected to recruitment maneuvers followed by setting PEEP at 5 and then either 15 or 20 cmH2O. Via computed tomography, lung aeration was determined. According to the findings, improved lung aeration after a rise in PEEP was not always consistent with decreased shunt and V/Q mismatch. The reason for the presence of detrimental alterations in shunt and V/Q mismatch on increase in PEEP, despite enhanced aeration, in patients may be explained by poorly matched redistribution of ventilation and perfusion, between dependent and non-dependent areas of the lung.

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