About PEEP

It is interesting that after almost 20 years we still do not have a standardized approach to PEEP and the level of appropriate PEEP is still controversial.

New advancements in technology give us the ability to easily measure the pressure-volume compliance curve at the bedside and should make for some interesting trials and ventilator manipulations in the next few years.  It is therefore imperative that new therapists and students be aware and comfortable with these advancements.
I suggest that knowledge of pressure-volume curves and how they are developed and used should be part of the curriculum for 3rd year students.  It is not enough to know about these but to have interactive ventilator labs using advanced lung simulators like the ASL 5000 that can model these dynamic lung conditions of both neonatal and adult patients be utilized.  We have the technology and should use it.

Maximal hysteresis: a new method to set positive
end-expiratory pressure in acute lung injury?

J. KOEFOED-NIELSEN
Denmark, 2Department of Anesthesia and Intensive Care, Aarhus University Hospital,
Aalborg, Denmark and 3Department of Radiology, Aarhus University Hospital, Skejby, Denmark
Acta Anaesthesiol Scand 2008; 52: 641–649
Printed in Singapore.


The article above and others like it look at possible technical and clinical challenges to the question of using PEEP and lung compliance curves.


I challenge all of us to keep up our knowledge of the research and technology associated with the evolution of the use of PEEP and clinical measurements of patient lung mechanics.