Setting positive end-expiratory pressure: Lung and diaphragm ultrasound

Amne Mousa, Peter Klompmaker, Pieter R. Tuinman

Research output: Contribution to journalReview articleAcademicpeer-review

2 Citations (Scopus)

Abstract

Purpose of reviewThe purpose of this review is to summarize the role of lung ultrasound and diaphragm ultrasound in guiding ventilator settings with an emphasis on positive end-expiratory pressure (PEEP). Recent advances for using ultrasound to assess the effects of PEEP on the lungs and diaphragm are discussed.Recent findingsLung ultrasound can accurately diagnose the cause of acute respiratory failure, including acute respiratory distress syndrome and can identify focal and nonfocal lung morphology in these patients. This is essential in determining optimal ventilator strategy and PEEP level. Assessment of the effect of PEEP on lung recruitment using lung ultrasound is promising, especially in the perioperative setting. Diaphragm ultrasound can monitor the effects of PEEP on the diaphragm, but this needs further validation. In patients with an acute exacerbation of chronic obstructive pulmonary disease, diaphragm ultrasound can be used to predict noninvasive ventilation failure. Lung and diaphragm ultrasound can be used to predict weaning outcome and accurately diagnose the cause of weaning failure.SummaryLung and diaphragm ultrasound are useful for diagnosing the cause of respiratory failure and subsequently setting the ventilator including PEEP. Effects of PEEP on lung and diaphragm can be monitored using ultrasound.
Original languageEnglish
Pages (from-to)53-60
Number of pages8
JournalCurrent Opinion in Critical Care
Volume30
Issue number1
DOIs
Publication statusPublished - 1 Feb 2024

Keywords

  • diaphragm
  • lung
  • mechanical ventilation
  • positive end-expiratory pressure
  • ultrasonography

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