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Rebuttal From Dr Miller et alRebuttal From Dr Miller et al

Russell R. Miller, III, MD, MPH; Neil R. MacIntyre, MD, FCCP; R. Duncan Hite, MD, FCCP; Jonathon D. Truwit, MD, MBA, FCCP; Roy G. Brower, MD; Alan H. Morris, MD, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Medicine (Drs Miller and Morris), Intermountain Medical Center; Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine (Drs Miller and Morris), University of Utah School of Medicine; Division of Pulmonary and Critical Care Medicine (Dr MacIntyre), Duke University; Division of Pulmonary, Critical Care, Allergy, and Immunologic Medicine (Dr Hite), Wake Forest University; Division of Pulmonary and Critical Care Medicine (Dr Truwit), University of Virginia; and Pulmonary and Critical Care Medicine (Dr Brower), Johns Hopkins University School of Medicine.

Correspondence to: Russell R. Miller III, MD, MPH, Respiratory Intensive Care Unit, Intermountain Medical Center, 5121 S Cottonwood St, Murray, UT 84107; e-mail: Russ.Miller@imail.org


Funding/Support: This work was supported in part by the National Institutes of Health [HHSN268200536171C/N01-HR-56171; HHSN268200536169C/N01-HR-56169; HHSN268200536175C/N01-HR-56175; HHSN268200536170C/N01-HR-56170].

Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr MacIntyre has been a consultant for CareFusion Corporation since 1985. Dr Hite currently is a National Institutes of Health-funded investigator for studies related to ARDS. He also serves as a consultant (data safety and monitoring board chair) for a clinical trial sponsored by Cumberland Pharmaceuticals Inc and is a shareholder in Discovery Laboratories, Inc (both unrelated to the content of this article). Dr Hite has been an unfunded speaker on the subject of mechanical ventilation and ARDS, which is relevant to the content of this article. Dr Truwit has received National Institutes of Health grant funding in ARDS and an ARDS-surfactant grant from PneumoPartners. Drs Miller, Brower, and Morris have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


© 2012 American College of Chest Physicians


Chest. 2012;141(6):1384-1386. doi:10.1378/chest.12-0156
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Extract

Application of positive end-expiratory pressure (PEEP) in ARDS is evolving. Higher PEEP may prove beneficial in some patients with ARDS.1 We propose combining PEEP and Fio2 using a table. Dr Schmidt2 has appropriately pointed out several limitations of this method and suggested alternative strategies to management of PEEP. However, we remain unconvinced that these have been tested sufficiently to prove their reliability, safety, or overall clinical effectiveness.

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