Titrating PEEP in ARDS Key Principles: 1) The ideal PEEP optimizes alveolar recruitment and reduces atelectrauma, while minimizing over-distension and barotrauma 2) Variables to monitor with PEEP titrations are: • Plateau pressure (Pplat) • Driving pressure (ΔP = Pplat - PEEP) • Oxygenation • Blood pressure 3) No one method has proven to be the superior option for titrating PEEP 4) Optimal PEEP is dynamic, and should be re-assessed frequently 5) High-PEEP recruitment maneuvers are harmful and should be avoided Optimize PEEP with one of these methods: • Driving Pressure and Incremental / Decremental PEEP trial • Esophageal Manometry • Pressure - Volume Loop • Stress Index By @PulmPEEPs #PEEP #ARDS #titration #management #criticalcare #pulmonary
