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Sample text

8,9 In patients with acute lung injury (ALI) and ARDS, lung units collapse largely because of compressive forces, especially in dependent lung zones. One would anticipate PEEP to be effective in keeping the lung open when it produces a positive transpulmonary pressure. 10 Raising PEEP to produce a positive transpulmonary pressure raised oxygenation and compliance and produced a trend toward higher survival. 11,12 Normally the airway opening pressure rises linearly during constant flow, volume-controlled ventilation because respiratory system mechanical properties (compliance and resistance) do not vary much over the tidal range.

Org/ 07/19/2012 ACCP Care Medicine Board Review:on21st Edition Two parallel processes synergistically interact and result in hypertensive emergency. 11 Once the clinical picture of the patient is classified as emergency vs urgency, appropriate therapy can be instituted. Principles of Treatment of Hypertensive Urgencies and Emergencies Figure 1. Cerebral blood flow autoregulation. Reprinted with permission from ACCP Critical Care Medicine Board Review. 20th ed. Northbrook, IL: American College of Chest Physicians; 2009.

The components include elevation of the head of the bed to 308 or greater; daily sedative interruption; daily spontaneous breathing trials; deep venous thrombosis prophylaxis; and preventive measures to reduce the risk of GI hemorrhage. 8. 9. Nothing to Disclose The author has disclosed that no relationships exist with any companies/organizations whose products or services may be discussed in this chapter. References 1. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome: the Acute Respiratory Distress Syndrome Network.

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