What is the role of PEEP in the treatment of drowning patients?

Updated: Jun 19, 2019
  • Author: G Patricia Cantwell, MD, FCCM; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Intubated victims of submersion injury may require PEEP with mechanical ventilation to maintain adequate oxygenation. PEEP has been shown to improve ventilation patterns in the noncompliant lung in several ways, including the following:

  • Provides distending pressure to improve volume of gas at the end of exhalation (increases functional residual capacity)

  • Minimizes atelectasis or alveolar collapse by maintaining pressure above which the lungs collapse (closing pressure)

  • Decreases intrapulmonary shunting of blood and improves arterial oxygenation

  • Increases intrathoracic pressure, which transmits the applied PEEP to transmural capillary pressure (results in minimizing interstitial lung water)

  • Increases the diameter of both small and large airways to improve distribution of ventilation


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