Advantages and Rationale for Pressure Controlled Ventilation
Ashbaugh and colleagues  in 1969 have used low levels positive end-expiratory pressure (PEEP) with volume controlled ventilation (VCV) (5–10 cm H2O) in the treatment of hypoxemia in adult respiratory distress syndrome (ARDS). They also indicated that higher levels of PEEP could cause barotrauma, decrease cardiac output and therefore decrease O2 transport although PaO2 is increased. Falke and coworkers  defined in 1972 the “optimal PEEP” as a level of PEEP which provided a PaO2 > 100 mm Hg with FiO2 ≤0.5. In 1975, Suter and colleagues  accepted the “optimal PEEP” as a value providing best oxygen transport and lung compliance, which could be obtained with a PEEP level up to 12 cm H2O. Application of PEEP has been reported to lower cardiac output [3, 4]. However, Qvist et al.  demonstrated in 1975 that the adverse hemodynamic effects of PEEP could be limited by additional fluid administration.
KeywordsSurfactant Dioxide Depression Washout Pneumothorax
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