理解的对吗？

Ideally, a“best PEEP” simultaneously: (1) provides appropriate gas-exchange; (2) keeps the lungs open (prevents phasic airway collapse); (3) avoids alveolar overdistension; and (4) does not compromise hemodynamics. This PEEP‘grail’ simply does not exist. Any PEEP selected is always a compromise among these objectives—a balance which over time tilts increasingly toward its complications. With only isolated exceptions, the quest for an ‘optimal PEEP’ approach has focused on passive airway pressure and has largely ignored the potentially important influences of disease stage, chest wall stiffness, massive obesity, baby lung capacity, vertical torso angulation, supine/prone body positioning, regional compliance, and need for frequent PEEP reassessment as disease progresses or resolves.

理想情况下，“最佳PEEP”可同时：（1）提供适当的气体交换；（2）保持肺开放（防止时相性气道塌陷）；（3）避免肺泡过度膨胀；和（4）不损害血流动力学。这种“理想”PEEP根本不存在。任何PEEP的确定始终应在这些目标间取得平衡——随着时间的推移，平衡越来越复杂。除了个别的例外，寻求“最佳PEEP”方法主要关注被动气道压，且在很大程度上忽略了疾病分期、胸壁僵硬度、严重肥胖、小肺、垂直轴成角、仰卧/俯卧体位、局部顺应性的潜在重要影响,以及随疾病进展或好转需要频繁重新评估PEEP的重要性。

谢谢