Early positive end-expiratory pressure in the adult respiratory distress syndrome. Arch Surg 1979 Apr;114(4):497-501
Date
04/01/1979Pubmed ID
373705DOI
10.1001/archsurg.1979.01370280151024Scopus ID
2-s2.0-0018358648 (requires institutional sign-in at Scopus site) 66 CitationsAbstract
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 less than .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.
Author List
Weigelt JA, Mitchell RA, Snyder WH 3rdMESH terms used to index this publication - Major topics in bold
Clinical Trials as TopicFemale
Humans
Hypoxia
Male
Middle Aged
Positive-Pressure Respiration
Postoperative Complications
Prospective Studies
Random Allocation
Risk
Shock
Time Factors
Wounds and Injuries