Lung ultrasound- versus FiO-guided PEEP in ARDS patients | ||
| Egyptian Journal of Anaesthesia | ||
| Volume 36, Issue 1, January 2020, Pages 31-37 PDF (943.58 K) | ||
| DOI: TEJA-2019-0083 | ||
| Authors | ||
| Mai S. Salem; Hesham S. Eltatawy; Ahmed A. Abdelhafez; Salah El-din I. Alsherif | ||
| Abstract | ||
| : Although FiO-determined PEEP is the standard in ARDS management, previous trials failed to show agreement on outcomes. Based on heterogeneous ARDS pathology, we evaluated the effect of LUS-determined PEEP on oxygenation and outcomes. : In this prospective, controlled trial, we randomly assigned 60 patients into LUS-determined PEEP (group l) and FiO-determined PEEP (group II). LUS-determined PEEP was based on LUS aeration score. Primary outcome was P/F ratio, secondary outcomes were; static compliance, 28-day mortality, duration of MV and length of ICU-stay. : P/F ratio was 266 ± 44.5 in group I, 233 ± 53.9 in group II. Static compliance was 54.8 ± 6.6 in group I, 45.9 ± 3.8 in group II. IQR of duration of MV was 4–6 with a median value of 5 in group l, 6–11.7 with a median value of 7.5 in group ll. 28-day mortality was 6.7% in group l, 30% in group ll. The relative risk of mortality in group II is more or less 5 times in group I (RR 4.87 with 95%CI of 1.492–15.893). IQR of organ dysfunction-free days was 16–19 with a median value of 18 in group l, 0–12 with a median value of 10 in group ll. IQR of MV-free days was 22–24 with a median value of 23 in group l, 0–22 with a median value of 20 in group ll. : LUS-guided PEEP showed improved oxygenation, compliance and decreased mortality, organ dysfunction, duration of MV and ICU compared with FiO-guided PEEP. | ||
| Keywords | ||
| ARDS; optimal PEEP; Oxygenation; 28-day mortality; lung ultrasound guided PEEP | ||
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