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Introduction: The "Express" strategy is a method for PEEP titration, where PEEP is set to reach an airway plateau pressure (Pplat) of 28 to 30 cmH2O in ARDS patients1.
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Many Method for setting PEEP have been proposed, but they are longstanding and difficult to perform in clinical practice, or based in oxygenation table, ignoring individual mechanical characteristics.
The present study enlightens as regards the safest and most efficient method for setting PEEP in acute respiratory distress syndrome (ARDS), and questions the classical view of 'keeping the lung open'.
Recently, Malbouisson and colleagues proposed a CT method for assessing PEEP-induced alveolar recruitment [ 18].
The stress index at post-RM could be a good method of PEEP titration for ARDS patients.
In the same county in 2002, Dear faced a misdemeanor charge for "peeping tom, eavesdropping or peeping".
Nevertheless, the identification of feasible bedside methods for "optimal" PEEP selection is still controversial.
Two published methods for setting PEEP were included for comparison based on the maximum global dynamic compliance and the intra-tidal compliance-volume curve.
Whereas Kiefer and colleagues used pressure volume curves for PEEP titration, we titrated PEEP on the basis of improvement in oxygenation, which is a commonly used method in clinical practice because determination of pressure volume curves can sometimes be cumbersome.
The objective of this study is to evaluate the value of dead space fraction (VD/VT) as a method for indicating the optimal PEEP titration.
Mergoni and colleagues have reported an original method for bedside measurement of PEEP-related alveolar recruitment [ 25].
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