Réglage du niveau de pression expiratoire positive au cours du syndrome de détresse respiratoire aiguë : un faux problème…

Whereas tidal volume reduction is now largely accepted as a prerequisite to protect the lungs in mechanically ventilated ARDS patients, a debate persists concerning the best PEEP to avoid excessive loss of functional residual capacity. This discussion should take into account the effect of PEEP application on pulmonary circulation, and not only on lung aeration, improvement in the latter usually being obtained at the expense of the former. An appropriate balance should thus be respected to obtain a functional, and not only anatomical, improvement.