TY - JOUR T1 - Optimal PEEP in the first week of life in mechanically ventilated extremely preterm newborn infants: Clinical setting vs. optimal seeting as registered by forced oscillation technique (FOT) JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P4136 AU - Chiara Veneroni AU - Linda Wallström AU - Emanuela Zannin AU - Raffaele Dellacà AU - Richard Sindelar Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P4136.abstract N2 - Recently it has been shown that the use of forced oscillation technique (FOT) allows identifying an optimal open-lung PEEP minimizing mechanical stress to the lungs (Kostic P, Crit Care. 2011).The aim of this study is to characterize the optimal mechanical PEEP settings in the first week of life in mechanically ventilated preterm newborns and to compare it to the PEEP set by current clinical approach.Four preterm newborns (GA=23-27wks, BW=467-964g) were studied at the first, third and seventh day of life. PEEP was increased by 2cmH2O above the clinically set PEEP and then decreased by four 5-minute steps of 1cmH2O. For each step total respiratory input reactance (Xrs) at 10Hz was measured at end-expiration by sinusoidal FOT overimposed on ventilation waveform. The optimal mechanical PEEP was defined as the PEEP at which the maximum of Xrs was reached (Dellaca', Int Care Med, 2011).Mean±SD values of the clinically set PEEPs and the mechanically optimal PEEPs are shown in Figure.The higher inter-subject and day-by-day variability of the mechanically optimal PEEP suggests that FOT could help in fine tuning PEEP settings related to the lung mechanical changes over time in each patient. Future studies will be address whether setting the mechanically optimal PEEP could be beneficial from a clinical point of view. ER -