What is the role of positive end-expiratory pressure (PEEP) in the treatment of respiratory failure?

Updated: Apr 07, 2020
  • Author: Ata Murat Kaynar, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

In an ARDS Network trial, higher PEEP produced better oxygenation and lung compliance but no benefit to survival, time on ventilator, or nonpulmonary organ dysfunction. [3] Although sufficient PEEP is essential in ventilator management of patients with ARDS, this level varies from patient to patient. Ideal PEEP helps to achieve adequate oxygenation and decrease the requirement for high fractions of inspiratory oxygen without causing any of the harmful effects of PEEP.

Current evidence does not support routine application of high PEEP strategy in people with ALI or ARDS; however, a study by Briel et al found higher PEEP levels have been associated with improved survival among patients with ARDS. [10]


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