Positive end expiratory pressure

Positive end expiratory pressure (PEEP) is a modality used in positive pressure ventilation to prevent the alveoli returning to atmospheric pressure during expiration. It is routinely set between 3-5cmH2O; however, in severe respiratory failure it will often need to exceed 10cmH2O to be above the lower inflexion point of the pressure-volume curve. This has been suggested as beneficial in patients with severe ARDS. It rarely needs to exceed 20cmH2O to avoid cardiorespiratory complications and alveolar over-distension (see below). It does not prevent nor attenuate ARDS, or reduce capillary leak or lung water.

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