![]() ![]() 27-4), and therefore the work of breathing, is reduced. By applying external PEEP at a level similar to that of the generated auto-PEEP, the inspiratory threshold load (see Fig. 22 Patients with increased airways resistance whose ventilators are set to an inadequate expiratory time may trap gas and generate auto-PEEP. High levels of PEEP (15 to 20 cm H 2O) may be required in patients with acute respiratory distress syndrome (ARDS). 20,21 A low level of PEEP (5 cm H 2O) should be applied to all patients who are invasively ventilated. This improves oxygenation, increases lung compliance, and reduces the risk of developing ventilator-induced lung injury. ![]() PEEP reduces extravascular lung water, prevents the opening and closing of small airways, and helps to recruit collapsed alveoli. It is applied by placing a pressure-limiting valve on the expiratory limb of the ventilator circuit. PEEP is positive pressure within the alveoli at endexpiration. ![]() David Buckley, Michael Gillham, in Cardiothoracic Critical Care, 2007 Positive End-Expiratory Pressure ![]()
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