Mechanical Ventilation: Which Patients Benefit from High PEEP?

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Among patients with hypoxaemia after cardiac surgery, the use of an intensive alveolar recruitment strategy compared with a moderate recruitment strategy resulted in less severe pulmonary complications during the hospital stay, according to a randomised clinical trial of postoperative ventilation published in JAMA.

In this trial, conducted by Alcino Costa Leme, RRT, PhD (Hospital Das ClĂ­nicas da FMUSP, University of Sao Paulo, Brazil) and colleagues, postoperative ventilation with a high PEEP level (157 patients) compared with a lower PEEP level (163 patients) resulted in a significant shift toward less severe pulmonary complications and was associated with a shorter length of intensive care unit stay (3.8 vs. 4.8 days) and hospital stay (10.9 vs. 12.4 days).

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