E. F. Klein

The effect of incremental PEEP on PaO 2 in patients with respiratory failure.

ONTRo LLD mechanical ventilation with C posit ve end-expiratory pressure (PEEP) € a s been reported to improve arterial oxygen in some patients with acute respiratory failure.1-G The PEEP administered often is arbitrarily selected, and levels in excess of 10 cm. H20 are rarely used.3-7~8 However, beneficial effects have been reported with up to 15 to 25 cm. H,O of PEEP.4,5s9 The present study was designed to determine whether, during patient management, a level of PEEP could be obtained which would provide an optimal arterial O2 tension (J’ao,) without compromising circulation.

A Comparison of Foam and Air-filled Endotracheal-tube Cuffs

The porimary cause of tracheal damage at the cuff site is high lateral-wall pressure leading to ischemia of the mucosa and its underlying structures. Recently, large-volume, low-pressure endotracheal tube cuffs have been used to minimize this complication. The authors compared the effects of a self-inflating polyurethane-foam cuff with those of a low-pressure, air-filled latex cuff in 35 patients who needed continuous ventilatory support and in 13 mongrel dogs. While the degree of damage caused by the two types of cuffs was not significantly different in dogs, in patients the foam cuff produced significantly less tracheal damage after 24 and 72 hours of continuous intubation.