UMEM Educational Pearls

Category: Critical Care

Title: PEEP in nonhypoxemic respiratory failure

Keywords: PEEP, respiratory failure, ventilator associated pneumonia (PubMed Search)

Posted: 8/19/2008 by Mike Winters, MD (Updated: 8/11/2020)
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PEEP in Nonhypoxemic Respiratory Failure

  • 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.