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July 2, 2008

Ventilation Strategies for Acute Lung Injury and Acute Respiratory Distress Syndrome

JAMA. 2008;300(1):39-43. doi:10.1001/jama.300.1.41-a

To the Editor: The studies by Dr Meade and colleagues1 and Dr Mercat and colleagues2 were intended to test a strategy aimed at maximizing alveolar recruitment while limiting hyperinflation. To guarantee applicability at the bedside, both studies made use of fixed targets such as plateau pressures or PEEP/FIO2 ratios with PEEP levels adjusted accordingly. Because PEEP levels were not primarily titrated, the question is how much this approach compromised the test of an “optimum-PEEP” in favor of a “feasible-PEEP.”

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