Positive end-expiratory pressure during mechanical ventilation and respiratory support in newborns and children

Positive end-expiratory pressure (PEEP) is used during non-invasive and invasive ventilation of newborns, infants and children. PEEP improves gas exchange by increasing the functional residual capacity, reducing respiratory effort, lowering requirements for respiratory mixture oxygen, and enabling a decrease in the peak inspiratory pressure (PIP) without decreasing the mean airway pressure. Its effects on the cardiovascular system appear to be insignificant, particularly in patients with severe respiratory failure that is not accompanied by circulatory insufficiency. The use of PEEP to provide the optimal conditions for improvement of gas exchange should be tailored individually for each patient under control of blood gas analysis, PIP and FiO2. This strategy minimises ventilator-induced lung injury and prevents the development of circulatory failure associated with ventilation. Nasal continuous positive airway pressure (NCPAP), used with various PEEP values, is a recognised treatment method of respiratory failure in newborns, especially in preterm infants.