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2007 ).The concern is that such low values of VT may overtime be insuf?cient to maintain alveolar recruit-ment, in particular when low PEEP settings areused (Keszler 2006). Due to the high risk of loss of bladder sensation and voidingdifficulties after the procedure, it is recommended to insert a suprapubic catheter at theend of the procedure. In theory, drugs inhibiting the sympathetic nervoussystem could be useful, but the evidence of eficacy of centralimidazoline receptor binding agents and peripheral ?-adrenergicblocking agents is not convincing. The most common types of shunts in usetoday are differential pressure valves that open when acertain pressure difference exists between the ventricu-lar side of the shunt and its distal end, which is mostoften placed intra-abdominally. Thiswound covering is left on for 5 to 6 days and can be used on a wound closed with staplesor suture.
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