PEEP



PEEP is part of the ventilation mode. Expresses positive pressure in the respiratory tract (pressure higher than atmospheric) at the end of exhalation (expiria). The abbreviation stands for positive end expiratory pressure,

The aim of its use is to increase the volume of gas that remains in the lungs at the end of exhalation, thereby improving gas exchange in the lungs, loosening atelectasis and increasing tidal volumes. Effects of including PEEP in the circuit:
 * Influence of the size of functional residual lung capacity – prevention of compression atelectasis, prevention of re-collapse of developed alveoli.
 * Influencing the distribution of ventilation and perfusion – improving the evenness of the flow and distribution of the breathing mixture, increasing blood flow and reducing vascular resistance in the lung tissue.
 * Influencing the work of breathing – facilitating inhalation and reducing the work of breathing.
 * Influence of the circulation – in the case of left ventricular failure, it supports oxygenation and reduces oxygen consumption by the myocardium, increases cardiac output → reduces venous return, afterload. n patients without heart failure, it reduces venous return → PEEP increases intrathoracic pressure.
 * Increases intra-abdominal pressure.

Indications: severe forms of COPD requiring ventilatory support, ARDS, pulmonary edema, shock lung

Distribution of PEEP:


 * Low PEEP → up to 5 cm H2O; used in patients without lung pathology and during short-term ventilation.
 * Moderate PEEP → 5–10 cm H2O; used in most patients.
 * High PEEP → above 15 cm H2O; indicated in patients with acute pulmonary failure.
 * PEEP above 30 cm H2O is used for the so-called opening maneuver.

PEEP values ​​of 4–8 cm H2O are commonly used. Higher PEEP values ​​of 8–15 cm H2O are used to prevent lung damage due to repeated openings and collapses of lung alveoli.


 * Intrinsic PEEP – also called auto PEEP, internal PEEP.
 * An essential part of monitoring in patients with pulmonary disease → extent of hyperinflation.
 * Method of measurement according to the patient's respiratory activity.

related articles

 * COPD
 * Lung volumes
 * Artificial lung ventilation
 * Artificial pulmonary ventilation/SŠ (nurse)
 * Non-invasive pulmonary ventilation/SŠ (nurse)