Fluctuating PEEP (F-PEEP) versus conventional PEEP in dogs with asymmetrical lung injury

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Abstract
Fluctuating PEEP (F–PEEP) is a newly developed PEEP in which end–expiratory pressure (EEP) is periodically changed within a certain range. In a dog model with unilateral lung injury induced by the introduction of hydrochloric acid, F–PEEP in which the EEP was periodically changed from 0.5 to 1.5 kPa at periods of 6 min, and conventional PEEP (C–PEEP) with an optimized EEP of 1.0 kPa, were each applied for 30 min. F–PEEP produced a significantly greater improvement of Pao2 and intrapulmonary shunt (Qs/Qr)than C–PEEP, and at the low EEP phase, the greatest improvement accompanied by an increased dynamic compliance and a large cardiac output was obtained. These results suggest that F–PEEP provides a useful mode of artificial ventilation for the treatment of unilateral lung injury.