Few actions taken by intensivists are as effective and inexpensive as application of positive end-expiratory pressure (PEEP). However, the use of this ventilatory modality is highly susceptible to fashions and trends that are rarely supported by scientific evidence. Prophylactic PEEP can be considered an exception, in that there is scientific evidence that it offers no benefit. Nevertheless, we...

Positive end-expiratory pressure (PEEP) has been extensively utilized in the treatment of severe hypoxemia from noncardiogenic pulmonary edema. The usefulness of therapy with PEEP in the management of lobar atelectasis has not been previously stressed. Recently, we observed four patients with lobar atelectasis who failed to respond to the usual conservative measures of endotracheal suctioning a...

BACKGROUND Cardiac surgery-related pulmonary complications include alterations in lung mechanics and anomalies in gas exchange. Higher levels of positive end-expiratory pressure (PEEP) have been suggested to benefit cardiac surgical patients. We compared respiratory compliance, arterial oxygenation and time till tracheal extubation in 2 cohorts of patients weaned from mechanical ventilation wit...

BACKGROUND Positive end-expiratory pressure (PEEP) is commonly used in clinical settings. It is expected to affect the input from slowly adapting pulmonary stretch receptors (SARs), leading to altered cardiopulmonary functions. However, we know little about how SARs behave during PEEP application. OBJECTIVES Our study aimed to characterize the behavior of SARs during PEEP application. METHO...

The pressure reactivity index (PRx) identifies optimal cerebral perfusion pressure after traumatic brain injury. We describe a method to improve PRx precision by induced variations in arterial blood pressure (ABP) using positive end-expiratory pressure (PEEP) modulation (iPRx). Neonatal swine (n = 10) were ventilated with static PEEP and then with PEEP oscillated between 5 and 10 cmH(2)O at a f...

BACKGROUND [Corrected] Expiratory positive airway pressure (EPAP) is used in after cardiac surgeries. However, its hemodynamic effects have not been clearly studied. OBJECTIVE To evaluate the hemodynamic changes caused by EPAP in patients after cardiac surgery monitored by Swan-Ganz. METHODS Patients at the first or second cardiac surgery postoperative period hemodynamically stable with a S...

Auto-positive end-expiratory pressure (auto-PEEP) is a common problem in patients receiving full or partial ventilatory support, as well as in those ready to be weaned from the ventilator. Physicians should be alert for it and take measures to reduce it, as it can have serious consequences.

Chest Harvey J. Sugerman, Robert M. Rogers and Leonard D. Miller Indications and Physiologic Considerations Positive End-Expiratory Pressure (PEEP); http://chestjournal.chestpubs.org/content/62/5_Supplement/86S can be found online on the World Wide Web at: The online version of this article, along with updated information and services ) ISSN:0012-3692 http://chestjournal.chestpubs.org/site/misc...