Title: PEEP in the Intubated Obese Patient<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
<strong><u>PEEP in the Intubated Obese Patient</u></strong></p>
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Obesity has numerous adverse effects on the respiratory system, most notably a reduction in lung volumes.</li>
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The reduction in lung volumes (i.e., FRC) often result in airway closure and atelectasis.</li>
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The application of PEEP in the mechanically ventilated patient helps maintain alveolar patency by preventing derecruitment.</li>
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Importantly, the typical initial PEEP setting of 5 cm H2O is insufficient for many ventilated obese patients.</li>
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<strong>Pearl: In the ventilated obese patient start with an initial PEEP of 10-15 cm H2O.</strong></li>
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<fieldset><legend>References</legend>
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De Jong A, et al. How to ventilate obese patients in the ICU. <em>Intensive Care Med.</em> 2020; 46:2423-35.</p>
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