PEEP titration in moderate to severe ARDS: plateau versus transpulmonary pressure.

Background: Although lung protection with low tidal volume and limited plateau pressure (P) improves survival in acute respiratory distress syndrome patients (ARDS), the best way to set positive end-expiratory pressure (PEEP) is still debated.

Methods: This study aimed to compare two strategies using individual PEEP based on a maximum P (28-30 cmHO, the Express group) or on keeping end-expiratory transpulmonary pressure positive (0-5 cmHO, P group). We estimated alveolar recruitment (Vrec), end-expiratory lung volume and alveolar distension based on elastance-related end-inspiratory transpulmonary pressure (P).

Subclavian central venous catheter-related thrombosis in trauma patients: incidence, risk factors and influence of polyurethane type.

Introduction: The incidence of deep venous thrombosis (DVT) related to a central venous catheter varies considerably in ICUs depending on the population included. The aim of this study was to determine subclavian central venous catheter (SCVC)-related DVT risk factors in severely traumatized patients with regard to two kinds of polyurethane catheters.

Methods: Critically ill trauma patients needing a SCVC for their usual care were prospectively included in an observational study.

Pneumocephalus following thoracic surgery: the implication of the epidural anesthesia is still exceptional.

Epidural analgesia is the gold standard for the management of pain after thoracopulmonary surgery. However, it is not without side-effects and complications. We report the case of a 52-year-old man who underwent left lower lobectomy for a carcinoid tumor.