RT Journal
A1 Weigelt JA, Mitchell RA, Snyder WH, III
T1 EArly positive end-expiratory pressure in the adult respiratory distress syndrome
JF Archives of Surgery
JO Archives of Surgery
YR 1979
FD April 1
VO 114
IS 4
SP 497
OP 501
DO 10.1001/archsurg.1979.01370280151024
UL http://dx.doi.org/10.1001/archsurg.1979.01370280151024
AB • This prospective study was designed to determine the effect of positive end-expiratory pressure (PEEP) instituted early in the course of adult respiratory distress syndrome (ARDS). Seventy-nine (7%) of 1,200 patients admitted to the surgical intensive care unit were selected because of a high probability that ARDS would develop, and were randomized into two treatment groups. Of the 79 patients, 45 were immediately treated with 5 cm H2O of end-expiratory pressure (early PEEP group), and 34 received PEEP only when severe hypoxemia developed (late PEEP group). The incidence of ARDS was significantly lower in the early PEEP group than in the late PEEP group (20% vs 53%; P <.002). Fewer pulmonary deaths occurred in this group (11% vs 29%; P =.02), and there was less pulmonary morbidity. This study supports the efficacy of early low-level PEEP in the treatment of patients for whom there is a high probability that ARDS will develop.(Arch Surg 114:497-501, 1979)