Current Concepts Positive End-Expiratory Pressure in Adult Respiratory Failure

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Abstract
Almost 15 years have passed since positive end-expiratory pressure (PEEP) was described as a treatment for the adult respiratory-distress syndrome.1 PEEP was observed to increase diminished functional residual capacity and to ameliorate arterial hypoxemia, which until then had often been untreatable even in patients given very high concentrations of oxygen. Recent reviews have addressed in detail the mechanisms of lung injury in adult respiratory-distress syndrome2 , 3 and the rationale for the use of PEEP in that syndrome.4 The purpose of this paper is to scrutinize specific controversial issues related to PEEP therapy that have arisen with its widespread use. We will . . .