RT Journal Article
SR Electronic
T1 Determining Baseline Positive End Expiratory Pressure to Minimize Driving Pressures
JF Respiratory Care
FD American Association for Respiratory Care
SP 3233657
VO 64
IS Suppl 10
A1 Forrette, Terry L
A1 Hunt, John
A1 Greiffenstein, Patrick
A1 Zamjahn, John
YR 2019
UL http://rc.rcjournal.com/content/64/Suppl_10/3233657.abstract
AB Background: We sought to determine what our baseline level of positive end expiratory pressure (PEEP) should be set at to minimize ventilator-induced lung injury (VILI). Amato and co-workers determined that a driving pressure (Pd) of 13 cm H2O or less reduced the incidences of VILI. They determined Pd by subtracting PEEP from plateau pressure (Pplat). Methods: After receiving IRB approval, we first measured Pd, using the inspiratory pause function on the ventilator to obtain a Pplat level, at our standard baseline PEEP of 5 cm H2O on 66 patients in our Level 1 trauma ICU (TICU). Following an initial analysis of these patients we elevated the baseline PEEP to 8 cm H2O and measured Pd on 112 patients in the TICU. Patients from both groups were ventilated at 6 mL/kg/PBW in either the AC or PAV ventilation mode. Results: The results of our study showed a significant difference, P < .05 in Pd between 5 and 8 of PEEP. Conclusions: Our data reflects that of others suggesting that a higher level of PEEP may aid in reducing VILI. Following this study our ventilator protocol was changed to an entry PEEP level of 8 cm H2O.