The “open lung” compromise

John J. Marini

Research output: Chapter in Book/Report/Conference proceedingChapter


How best to select positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS) remains among the most actively debated questions critical care practice. Controversy stems partially fromimprecision of disease diagnosis, confusion about which objective to prioritize, and uncertainty regarding safe limits for airway pressure. Perhaps the root cause such indecisiveness, however, involves the mechanical heterogeneity of the acutely diseased lung coupled with the need to set only one PEEP value. In fact, when lung protection is the issue, PEEP selection is always a trade of between improving recruitment and increasing tissue stress. The article by Di Rocco and colleagues in the issue [1] offers novel experimental data that address how that compromise is best struck.

Original languageEnglish (US)
Title of host publicationApplied Physiology in Intensive Care Medicine 2
Subtitle of host publicationPhysiological Reviews and Editorials
PublisherSpringer Berlin Heidelberg
Number of pages3
ISBN (Electronic)9783642282331
ISBN (Print)9783642282324
StatePublished - Jan 1 2012

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