Related Experiment Video

Updated: Jul 9, 2025

Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit
05:56

Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit

Published on: September 6, 2024

2.2K

Positive end-expiratory pressure in the pediatric intensive care unit

Martin C J Kneyber1

  • 1Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Anaesthesiology, Peri-operative & Emergency Medicine, University of Groningen, Groningen, the Netherlands.

Paediatric Respiratory Reviews
|November 29, 2023
PubMed

Insights

Positive end-expiratory pressure (PEEP) is crucial for managing pediatric acute respiratory distress syndrome (PARDS). Optimal PEEP titration improves oxygenation and lung mechanics, potentially enhancing patient outcomes in PARDS.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Physiology
  • Mechanical Ventilation

Background:

  • Positive end-expiratory pressure (PEEP) is a key component in managing pediatric acute respiratory distress syndrome (PARDS).
  • Low PEEP levels can lead to alveolar instability, surfactant dysfunction, and lung injury.
  • This instability increases lung strain in aerated regions due to preferential tidal volume distribution.

Purpose of the Study:

  • To highlight the importance of appropriate PEEP titration in PARDS management.
  • To discuss the negative consequences of low PEEP levels on lung mechanics and patient outcomes.
  • To emphasize the need for a comprehensive approach to PEEP setting in PARDS.

Main Methods:

  • Review of current practices and literature regarding PEEP application in PARDS.
  • Discussion of the physiological impact of PEEP on lung volumes, alveolar stability, and lung strain.
  • Reference to guidelines and recommendations from the Pediatric Acute Lung Injury Consensus Conference (PALICC).

Main Results:

  • Low PEEP levels are commonly used by practitioners, often accompanied by higher fraction of inspired oxygen (FiO2).
  • This practice may negatively impact patient outcomes in PARDS.
  • PEEP titration should consider multiple parameters, not just isolated clinical measures.

Conclusions:

  • Optimizing PEEP is essential for improving oxygenation and lung protection in PARDS.
  • PEEP should be titrated based on oxygenation, oxygen delivery, hemodynamics, and static compliance.
  • Adherence to limits on plateau and/or driving pressures is critical during PEEP titration in PARDS.

Keywords:
Acute respiratory distress syndromeDriving pressurePersonalized positive end-expiratory pressure titrationPositive end-expiratory pressureRecruitment maneuverVentilator-induced lung injury

More Related Videos

Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism09:31

Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism

Published on: February 14, 2022

2.1K
Guidelines for Elective Pediatric Fiberoptic Intubation11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

17.6K

Related Concept Videos

Mechanical Ventilation III: Noninvasive Ventilation01:23

Mechanical Ventilation III: Noninvasive Ventilation

Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
125
Mechanical Ventilation II: Invasive Ventilation01:23

Mechanical Ventilation II: Invasive Ventilation

Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
152
Mechanical Ventilation I: Indication and Settings01:29

Mechanical Ventilation I: Indication and Settings

Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
403
Ventilatory Modes01:14

Ventilatory Modes

Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
166
Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
1.6K
Chest Physiotherapy01:24

Chest Physiotherapy

Chest Physiotherapy (CPT) is a therapeutic technique used in respiratory care to improve ventilation, clear bronchial secretions, and enhance the efficiency of respiratory muscles. This therapy includes three primary procedures: postural drainage, percussion, and vibration. It can be performed on spontaneously breathing patients and those who are intubated and mechanically ventilated.
Purpose
CPT is primarily used for patients with excessive bronchial secretions who have difficulty clearing...
476