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High versus low positive end-expiratory pressure (PEEP) levels for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome

  1. Roberto Santa Cruz1,*,
  2. Juan Ignacio Rojas2,
  3. Rolando Nervi1,
  4. Roberto Heredia1,
  5. Agustín Ciapponi3

Editorial Group: Cochrane Anaesthesia, Critical and Emergency Care Group

Published Online: 6 JUN 2013

Assessed as up-to-date: 6 MAY 2013

DOI: 10.1002/14651858.CD009098.pub2


How to Cite

Santa Cruz R, Rojas JI, Nervi R, Heredia R, Ciapponi A. High versus low positive end-expiratory pressure (PEEP) levels for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD009098. DOI: 10.1002/14651858.CD009098.pub2.

Author Information

  1. 1

    Hospital Regional of Rio Gallegos, Department of Intensive Care, Rio Gallegos, Argentina

  2. 2

    Hospital Italiano Buenos Aires, Neurology Department, Buenos Aires, Buenos Aires, Argentina

  3. 3

    Southern American Branch of the Iberoamerican Cochrane Centre, Argentine Cochrane Centre IECS, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Capital Federal, Argentina

*Roberto Santa Cruz, Department of Intensive Care, Hospital Regional of Rio Gallegos, Jose Ingenieros 95, Rio Gallegos, 9400, Argentina. resc.hrrg@gmail.com.

Publication History

  1. Publication Status: New
  2. Published Online: 6 JUN 2013

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Amato 1998 {published data only}
  • Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, et al. Effects of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. New England Journal of Medicine 1998;338:347-54. [PUBMED: 9449727]
Brower 2004 {published data only}
  • Brower RG, Lanken PN, MacIntyre N, Matthay MA, Morris A, Ancukiewicz M, et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. New England Journal of Medicine 2004;351:327-36. [PUBMED: 15269312]
Huh 2009 {published data only}
  • Huh JW, Jung H, Choi HS, Hong SB, Lim CM, Koh Y. Efficacy of positive end-expiratory pressure titration after the alveolar recruitment manoeuvre in patients with acute respiratory distress syndrome. Critical Care 2009;13:R22. [PUBMED: 19239703]
Meade 2008 {published data only}
  • Meade MO, Cook DJ, Guyatt GH, Slutsky AS, Arabi YM, Cooper DJ, et al. Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: A randomized controlled trial. JAMA 2008;299:637-45. [PUBMED: 18270352]
Mercat 2008 {published data only}
  • Mercat A, Richard JC, Vielle B, Jaber S, Osman D, Diehl JL, et al. Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: A randomized controlled trial. JAMA 2008;299:646-55. [PUBMED: 18270353]
Talmor 2008 {published data only}
  • Talmor D, Sarge T, Malhotra A, O´Donnell CR, Ritz R, Lisbon A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury. New England Journal of Medicine 2008;359:2095-104. [PUBMED: 19001507]
Villar 2006 {published data only}
  • Villar J, Kacmarek RM, Perez-Mendez L, Aguirre-Jaime A. A high positive end-expiratory pressure, low tidal volume ventilatory strategy improves outcome in persistent acute distress syndrome: A randomized, controlled trial. Critical Care Medicine 2006;34:1311-18. [PUBMED: 16557151]

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Amato 1995 {published data only}
  • Amato MB, Barbas CS, Medeiros DM, Schettino GP, Lorenzi-Filho G, Kairalla RA, et al. Beneficial effects of the "open lung approach" with low distending pressures in acute respiratory distress syndrome: A prospective randomized study on mechanical ventilation. American Journal of Respiratory and Critical Care Medicine 1995;152:1835-46. [PUBMED: 8520744]
Badet 2009 {published data only}
  • Badet M, Bayle F, Richard JC, Guerin C. Comparison of optimal positive end-expiratory pressure and recruitment maneuvers during lung-protective mechanical ventilation in patients with acute lung injury/acute respiratory distress syndrome. Respiratory Care 2009;54:847-54. [PUBMED: 19558735]
Burns 2001 {published data only}
  • Burns D, West TA, Hawkins K, O'Keefe G. Immediate effects of positive end-expiratory pressure and low and high tidal volume ventilation upon gas exchange and compliance in patients with acute lung injury. The Journal of Trauma 2001;51:1177-81. [PUBMED: 11747202]
Carvalho 1997 {published data only}
  • Carvalho CR, Barbas CS, Medeiros DM, Magaldi RB, Lorenzi Filho G, Kairalla RA, et al. Temporal hemodynamic effects of permissive hypercapnia associated with ideal PEEP in ARDS. American Journal of Respiratory and Critical Care Medicine 1997;156:1458-66. [PUBMED: 9372661]
Dellamonica 2011 {published data only}
  • Dellamonica J, Lerolle N, Sargentini C, Beduneau G, Di Marco F, Mercat A, et al. PEEP-induced changes in lung volume in acute respiratory distress syndrome. Two methods to estimate alveolar recruitment. Intensive Care Medicine 2011;37:1595-604. [PUBMED: 21866369]
Grasso 2005 {published data only}
  • Grasso S, Fanelli V, Cafarelli A, Anaclerio R, Amabile M, Ancona G, et al. Effects of high versus low positive end-expiratory pressures in acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine 2005;171:1002-8. [PUBMED: 15665322]
Grasso 2007 {published data only}
  • Grasso S, Stripoli T, De Michele M, Bruno F, Moschetta M, Angelelli G, et al. ARDSnet ventilatory protocol and alveolar hyperinflation. Role of positive end-expiratory pressure. American Journal of Respiratory and Critical Care Medicine 2007;176:761-7. [PUBMED: 17656676]
Kallet 2007 {published data only}
  • Kallet RH, Branson RD. Do the NIH ARDS clinical trials network PEEP/FIO2 tables provide the best evidence-based guidance to balancing PEEP and FIO2 settings in adults?. Respiratory Care 2007;52:461-75. [PUBMED: 17417980]
Oczenski 2004 {published data only}
  • Oczenski W, Hormann C, Keller C, Lorenzi N, Kepka A, Schwarz S, et al. Recruitment maneuvers after a positive end-expiratory pressure trial do not induce sustained effects in early adult respiratory distress syndrome. Anesthesiology 2004;101:620-5. [PUBMED: 15329586 ]
Ranieri 1999 {published data only}
  • Ranieri VM, Suter PM, Tortorella C, De Tullio R, Dayer JM, Brienza A, et al. Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome. JAMA 1999;282:54-61. [PUBMED: 10404912]
Richard 2003 {published data only}
  • Richard JC, Brochard L, Vandelet P, Breton L, Maggiore SM, Jonson B, et al. Respective effects of end-expiratory and end-inspiratory pressures on alveolar recruitment in acute lung injury. Critical Care Medicine 2003;31:89-92. [PUBMED: 12544999]
Toth 2007 {published data only}
  • Toth I, Leiner T, Mikor A, Szakmany T, Bogar L, Molnar Z. Hemodynamic and respiratory changes during lung recruitment and descending optimal positive end-expiratory pressure titration in patients with acute respiratory distress syndrome. Critical Care Medicine 2007;35:787-93. [PUBMED: 17255855]

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Kacmarek 2007 {published data only}
  • ARDSnet Protocol vs Open Lung Approach in ARDS. Ongoing study February 1, 2007..
Pintado 2003 {published data only}
  • Pilot study of positive end-expiratory pressure in acute respiratory distress syndrome (PEEP-HUPA).. Ongoing study January 2003..

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
ARDSnet 2000
  • Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. New England Journal of Medicine 2000;342:1301-8. [PUBMED: 10793162]
Bernard 1994
  • Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, et al. The American-European Consensus Conference on ARDS. Definitions, mechanism, relevant outcomes, and clinical trial coordination. American Journal of Respiratory and Critical Care Medicine 1994;149:818-24. [PUBMED: 7509706]
Borges 2006
  • Borges JB, Okamoto VN, Matos GFJ, Caramez MPR, Arantes PR, Barrios F, et al. Reversibility of lung collapse and hypoxemia in early acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine 2006;174:268-78. [PUBMED: 16690982]
Briel 2010
  • Briel M, Meade M, Mercat A, Brower RG, Talmor D, Walter SD, et al. Higher vs lower positive end-expiratory pressures in patients with acute lung injury and acute respiratory distress syndrome. JAMA 2010;303:865-73. [PUBMED: 20197533]
Caironi 2010
  • Caironi P, Cressoni M, Chiumello D, Ranieri M, Quintel M, Russo S, et al. Lung opening and closing during ventilation of acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine 2010;181:578-86. [PUBMED: 19910610]
Coffey 1983
  • Coffey RL, Albert RK, Robertson HT. Mechanisms of physiological dead space response to PEEP after acute oleic acid lung injury. Journal of Applied Physiology 1983;55:1550-7. [PUBMED: 6358162]
Dasenbrook 2011
  • Dasenbrook EC, Needham DM, Brower RG, Fan E. Higher PEEP in patients with acute lung injury: A systematic review and meta-analysis. Respiratory Care 2011;56:568-75. [PUBMED: 21276322]
Dorinsky 1983
Eisner 2002
  • Eisner MD, Thompson BT, Schoenfeld D, Anzueto A, Matthay MA. Airway pressures and early barotrauma in patients with acute lung injury and acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine 2002;165:978-82. [PUBMED: 11934725]
Gattinoni 1993
  • Gattinoni L, D'andrea L, Pelosi P, Vitale G, Pesenti A, Fumagalli R. Regional effects and mechanism of positive end-expiratory pressure in early adult respiratory distress syndrome. JAMA 1993;16:2122-7. [PUBMED: 8468768]
Gattinoni 2006
  • Gattinoni L, Caironi P, Cressoni M, Chiumello D, Ranieri VM, Quintel M, et al. Lung recruitment in patients with the acute respiratory distress syndrome. New England Journal of Medicine 2006;354:1775-86. [PUBMED: 16641394]
Gordo-Vidal 2007
  • Gordo-Vidal F, Gómez-Tello V, Palencia-Herrejón E, Latour-Pérez J, Sánchez-Artola B, Díaz-Arlesi R. High PEEP vs conventional PEEP in the acute respiratory distress syndrome: a systematic review and meta-analysis. Medicina Intensiva 2007;9:491-501. [PUBMED: 18039449]
Grasso 2002
  • Grasso S, Mascia L, Del Turco M, Malacarne P, Giunta F, Brochard L, et al. Effects of recruiting maneuvers in patients with acute respiratory distress syndrome ventilated with protective ventilatory strategy. Anesthesiology 2002;96:795-802. [PUBMED: 11964585]
Guyatt 2008
  • Guyatt GH, Oxman AD, Kunz R, Vist GE, Falck-Ytter Y, Schunemann HJ. What is "quality of evidence" and why is it important to clinicians. British Medical Journal 2008;336:995-8. [PUBMED: 18456631]
Hess 2011
Higgins 2003
Higgins 2011
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Hodgson 2009
Imberger 2010
  • Imberger G, McIlroy D, Pace N, Wetterslev J, Brok J, Møller A. Positive end-expiratory pressure (PEEP) during anaesthesia for the prevention of mortality and postoperative pulmonary complications. Cochrane Database of Systematic Reviews 2010, Issue 9. [DOI: 10.1002/14651858.CD007922]
Jedlinska 2000
  • Jedlinska B, Mellström A, Jönsson K, Hartmann M. Influence of positive end-expiratory pressure ventilation on peripheral tissue perfusion evaluated by measurements of tissue gases and pH. An experimental study in pigs with oleic acid lung injury. European Surgical Research 2000;32:228-35. [PUBMED: 11014924]
Lachmann 2007
  • Lachmann RA, van Kaam AH, Haitsma JJ, Lachmann B. High positive end-expiratory pressure levels promote bacterial translocation in experimental pneumonia. Intensive Care Medicine 2007;33:1800-4. [PUBMED: 17576531]
Liberati 2009
  • Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Medicine 2009;6(7):e1000100. [PUBMED: 19621070]
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Oba 2009
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Petrucci 2007
Phoenix 2009
  • Phoenix SI, Paravastu S, Columb M, Vincent JL, Nirmalan M. Does a higher positive end expiratory pressure decrease mortality in acute respiratory distress syndrome? A systematic review and meta-analysis. Anesthesiology 2009;110:1098-105. [PUBMED: 19352160]
Putensen 2009
  • Putensen C, Theuerkauf N, Zinserling J, Wrigge H, Pelosi P. Meta-analysis: Ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury. Annals of Internal Medicine 2009;151:566-76. [PUBMED: 19841457]
Ranieri 1991
  • Ranieri VM, Eissa NT, Corbeil C, Chassé M, Braidy J, Matar N, et al. Effects of positive end-expiratory pressure on alveolar recruitment and gas exchange in patients with the adult respiratory distress syndrome. American Review of Respiratory Diseases 1991;144:544-51. [PUBMED: 1892293]
Ranieri 2012
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  • Weg JG, Anzueto A, Balk RA, Wiedemann HP, Pattishall EN, Schork MA, et al. The relation of pneumothorax and other air leaks to mortality in the acute respiratory distress syndrome. New England Journal of Medicine 1998;338:341-6. [PUBMED: 9449726]
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