The variable effect of PEEP in acute respiratory failure associated with multiple trauma

A. Perel, D. Olschvang, D. Eimerl, R. Katzenelson, S. Cotev

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Both short and longterm effects of positive end-expiratory pressure (PEEP) on oxygenating capacity (OC) were investigated in three groups of patients with acute respiratory failure following multiple trauma (MT). Group A consisted of six patients with “uncomplicated” MT; Group B, eight patients with MT and generalized sepsis; Group C, nine patients with MT and lung contusion. OC was evaluated in terms of PaO2/FIO2 and P(A-a)DO2 on FIO 2 = 1.0. OC was markedly and equally reduced in the three patient groups before use of PEEP. The use of a mean PEEP of 6-7 cm H2O resulted in an initial improvement in mean PaO2/FIO2 of 152.5, 36.1, and 59.2 mm Hg, and an overall improvement of 196.8, 57.5, and 107.0 mm Hg in Groups A, B, and C, respectively. There was a similar improvement in both the initial and the overall effect of PEEP on P(A-a)DO2 in the three groups. The difference in the improvement in OC due to PEEP was statistically significant between Groups A and B. It is concluded that acute respiratory failure following MT includes a wide spectrum of clinical syndromes, and that the improvement in OC due to PEEP depends on the clinical syndrome that is responsible for the respiratory failure associated with MT.

Original languageEnglish
Pages (from-to)218-220
Number of pages3
JournalJournal of Trauma and Acute Care Surgery
Issue number3
StatePublished - Mar 1978
Externally publishedYes


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