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Rebuttal From Dr SchmidtRebuttal From Dr Schmidt

Gregory A. Schmidt, MD, FCCP
Author and Funding Information

From the Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa.

Correspondence to: Gregory A. Schmidt, MD, FCCP, Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa, 200 Hawkins Dr, C304-GH, Iowa City, IA 52246; e-mail: Gregory-a-schmidt@uiowa.edu


Financial/nonfinancial disclosures: The author has reported to CHEST 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):1386-1387. doi:10.1378/chest.12-0158
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Extract

There is little question that positive end-expiratory pressure (PEEP) has both beneficial and harmful consequences in ARDS, perhaps even simultaneously in the same patient.1 Teasing out the effects of PEEP from those due to tidal volume, ventilator mode, fractional inspired oxygen, sedative regimen, and fluid therapy challenges clinicians and investigators alike. Even our vocabulary—“best PEEP,” “least PEEP,” “open-lung PEEP,” “optimal PEEP”—testifies to the continued debate about how PEEP should be set. The stakes have risen lately with the demonstration that higher PEEP may improve survival for some patients.2,3

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