Authors:
Jean-Daniel Chiche, MD; Derek C. Angus, MD, MPH
Summary:
In this issue of JAMA, Meade and colleagues and Mercat and colleagues report the results of 2 large international trials of alternative strategies for setting positive end-expiratory pressure (PEEP) in ventilated patients with acute lung injury or acute respiratory distress syndrome. Both trials asked whether higher PEEP would reduce mortality, and both concluded it did not. Many readers not familiar with intensive care might reasonably wonder why such a seemingly innocuous intervention would deserve such attention, but the story behind PEEP is a long one, and these latest, largest trials do not provide a conclusion. They do, however, serve to demonstrate that answering even the simplest questions can become an endeavor of immense proportions.
Source:
JAMA. 2008; 299(6):693-695