Positive End-Expiratory Pressure
Positive end-expiratory pressure (PEEP) is the pressure applied to the airways and lungs during mechanical ventilation to prevent airway and alveolar collapse at the end of expiration.
PEEP is used for infants with respiratory distress syndrome (RDS) or those infants requiring mechanical ventilation in order to help maintain lung volume and alveolar oxygenation.
Available evidenceIn infants, thus far, evidence exists largely at the level of physiologic measures, rather than rigorous trials with moderate- or long-term, clinically relevant end points.
Avery showed that preventing alveolar collapse at low lung volumes with PEEP conserved surfactant function.
Bonta used individualized levels of PEEP as measured by transmitted esophageal pressures to obtain optimal lung opening, and this enabled him to maximize PaO2.
In adult ICUs, large trials optimized PEEP using simple incremental grids in acute respiratory distress syndrome (ARDS). For ARDS in...
KeywordsLung Volume Functional Residual Capacity Dynamic Compliance High Peep Alveolar Collapse
- Bamat N, Millar D, Suh S, Kirpalani H. Positive end expiratory pressure for preterm infants requiring CMV for RDS or BPD: a systematic review. Cochrane Neonatal Database in press, 2011.Google Scholar