Intensive Care Medicine

, Volume 45, Issue 9, pp 1315–1317 | Cite as

Effects of increasing PEEP on lung stress and strain in children with and without ARDS

  • Stavroula Ilia
  • Elisavet Geromarkaki
  • Panagiotis Briassoulis
  • Paraskevi Bourmpaki
  • Theonymfi Tavladaki
  • Marianna Miliaraki
  • George BriassoulisEmail author

Dear Editor,

The ratio of tidal volume to functional residual capacity (FRC), defined as “volumetric” strain, causes physical lung deformation. The corresponding change in transpulmonary pressure at end inspiration, defined as stress, is directly applied to the alveolus [1]. Both stress and strain may cause global or local lung deformation and microscopic or macroscopic tissue damage, representing significant determinants of ventilator-induced lung injury [1]. A modified nitrogen washout/washin technique, measuring end-expiratory lung volume (EELV), correlated well with computed tomography and was proposed as a valuable tool to optimize ventilator settings, improving lung protective ventilation [2]. The aim of this study was to evaluate the effect of positive end-expiratory pressure (PEEP) on EELV, compliance of the respiratory system (Crs), and stress/strain in children with acute respiratory distress syndrome (ARDS), and compare it with children “at risk of ARDS” and those with no...


Author contributions

SI, EG, and GB contributed to the conception and design of the research; SI and EG contributed to the acquisition and analysis of the data; PB, PB, and TT contributed to the acquisition of the data; SI, EG, and GB contributed to the interpretation of the data; SI and GB drafted the manuscript; SI, MM, PB, and GB critically revised the manuscript. All authors agree to be fully accountable for ensuring the integrity and accuracy of the work and read and approved the final manuscript.

Compliance with ethical standards

Conflicts of interest

The author declares that they have no conflict of interest.

Supplementary material

134_2019_5667_MOESM1_ESM.docx (35 kb)
Supplementary material 1 (DOCX 35 kb)
134_2019_5667_MOESM2_ESM.tiff (89 kb)
Supplementary material 2 (TIFF 88 kb)
134_2019_5667_MOESM3_ESM.tiff (81 kb)
Supplementary material 3 (TIFF 81 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Pediatric Intensive Care Unit, Medical School, University HospitalUniversity of CreteHeraklionGreece

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