Patients with ALI/ARDS typically receive PEEP to improve oxygenation
Patients without ALI/ARDS, however, receive PEEP less frequently (some recent reports indicate that < 50% of these patients receive PEEP)
A recent study by Spanish investigators found that the use of PEEP (5 - 8 cm H20) in nonhypoxemic patients decreased the incidence of ventilator-associated pneumonia and decreased the number of patients who developed hypoxemia
Interestingly, no differences were found in hospital mortality, duration of mechanical ventilation, or ICU LOS
Take Home Point: In nonhyoxemic intubated patients, the addition of 5-8 cm H20 of PEEP is a reasonable practice and may be beneficial in preventing VAP (pending further study)
References
Manzano F, Fernandez-Mondejar E, Colmenero M, et al. Positive end-expiratory pressure reduces incidence of ventilator-associated pneumonia in nonhypoxemic patients. Crit Care Med 2008;36:2225-2231.
