Recruitment Maneuvers and Higher PEEP, the So-Called Open Lung Concept, in Patients with ARDS

  • P. van der Zee
  • D. GommersEmail author
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)


The acute respiratory distress syndrome (ARDS) is a hypoxemic syndrome primarily treated using supportive mechanical ventilation. Although mechanical ventilation is life-saving, it can cause ventilator-induced lung injury (VILI). Therefore, the goal of mechanical ventilation is to achieve adequate gas exchange while minimizing lung injury. Multiple mechanical ventilation strategies have been developed to limit VILI. These strategies are based on the pathophysiological concept that alveolar overdistention, shear-stress, and atelectrauma (i.e., the cyclical opening and closing of unstable alveoli) are possible mechanisms that result in VILI. Targets that might aggravate or attenuate VILI, notably tidal volume and positive end-expiratory pressure (PEEP), have become the subject of extensive research.



We thank Nathalie Timmerman for her support in the preparation of figures.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Adult Intensive Care Medicine, Erasmus MCErasmus University RotterdamRotterdamThe Netherlands

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