Related Experiment Video

Updated: Jul 27, 2026

The Modified Temptation Resistance Task: A Paradigm to Elicit Children's Strategic Lie-telling
06:51

The Modified Temptation Resistance Task: A Paradigm to Elicit Children's Strategic Lie-telling

Published on: April 6, 2018

To PEEP or not to PEEP?

K M Bartholomew1, K G Brownlee, S Snowden

  • 1Neonatal Unit, St James's University Hospital, Leeds.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|May 1, 1994
PubMed

Insights

Reducing positive end expiratory pressure (PEEP) significantly impacts tidal volume in neonates. Small PEEP adjustments are more effective than peak inflation pressure (PIP) changes for ventilation control.

Area of Science:

  • Neonatal Medicine
  • Pediatric Critical Care
  • Respiratory Physiology

Background:

  • Positive end-expiratory pressure (PEEP) and peak inflation pressure (PIP) are critical ventilator settings in neonates.
  • The relative impact of PEEP versus PIP on tidal volume is not fully appreciated.
  • Ventilator-induced lung injury is a concern in neonatal respiratory support.

Purpose of the Study:

  • To quantify the relative effects of PEEP and PIP on tidal volume in ventilated preterm infants.
  • To compare the potency of PEEP adjustments versus PIP adjustments in altering tidal volume.
  • To inform optimal ventilator management strategies for neonates.

Main Methods:

  • Studied 21 preterm infants (38 ventilation instances), sedated and paralyzed.
  • Investigated the effects of controlled reductions in PEEP and increases in PIP on tidal volume.
  • Measured changes in tidal volume in response to specific PEEP and PIP manipulations.

Main Results:

  • A 1 cm H2O reduction in PEEP increased tidal volume by 14%, compared to 7% for a 2 cm H2O increase in PIP.
  • A 1 cm H2O increase in PEEP decreased tidal volume by 13%, compared to 6% for a 2 cm H2O decrease in PIP.
  • PEEP adjustments were twice as potent as PIP adjustments in altering tidal volume.

Conclusions:

  • Positive end-expiratory pressure (PEEP) is a significantly more potent modulator of tidal volume than peak inflation pressure (PIP) in ventilated neonates.
  • Small, precise adjustments in PEEP (0.5-1 cm H2O) can effectively optimize ventilation and CO2 elimination.
  • High PEEP levels (4-5 cm H2O) may potentially impair gas exchange and lead to lung overdistension.

More Related Videos

Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential07:11

Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential

Published on: May 25, 2020

Pupillometry to Assess Auditory Sensation in Guinea Pigs09:25

Pupillometry to Assess Auditory Sensation in Guinea Pigs

Published on: January 6, 2023

Related Concept Videos

Naturalistic Observations02:30

Naturalistic Observations

If you want to understand how behavior occurs, one of the best ways to gain information is to simply observe the behavior in its natural context. However, people might change their behavior in unexpected ways if they know they are being observed. How do researchers obtain accurate information when people tend to hide their natural behavior? As an example, imagine that your professor asks everyone in your class to raise their hand if they always wash their hands after using the restroom. Chances...
Leaky Scanning02:28

Leaky Scanning

During most eukaryotic translation processes, the small 40S ribosome subunit scans an mRNA from its 5' end until it encounters the first start AUG codon. The large 60S ribosomal subunit then joins the smaller one to initiate protein synthesis. The location of the translation initiation is largely determined by the nucleotides near the start codon as there may be multiple translation initiation sites present on the mRNA.  Marilyn Kozak discovered that the sequence RCCAUGG (where R stands for...
Assessment of apical pulse01:17

Assessment of apical pulse

Assessing the Apical Pulse
Assessing the apical pulse is a critical nursing procedure, particularly indicated for:
Piaget's Stage 1 of Cognitive Development01:14

Piaget's Stage 1 of Cognitive Development

The sensorimotor stage, the initial phase of Jean Piaget's theory of cognitive development, spans the first two years of a child's life. During this period, infants actively engage with their surroundings, building cognitive awareness through direct interaction with the world. This interaction is primarily based on sensory perception and motor actions, allowing infants to gradually understand basic physical properties and predict how objects interact within their environment.
Exploration...
Strategies of Self-Presentation III: Self-Monitoring01:24

Strategies of Self-Presentation III: Self-Monitoring

Self-monitoring is a central construct in understanding individual differences in self-presentation strategies across social contexts. It refers to how individuals observe, regulate, and control their expressive behavior and self-presentation following situational cues. Self-monitoring reflects a person's sensitivity to social appropriateness and willingness to adapt behavior to fit varying interpersonal demands.High vs. Low Self-Monitoring IndividualsIndividuals high in self-monitoring are...
Introspection01:29

Introspection

Introspection, long upheld as a reliable route to self-knowledge, involves examining one's thoughts, emotions, and mental processes. It underpins many psychological practices, from mindfulness meditation to psychotherapy and self-help strategies. However, empirical evidence challenges the accuracy of introspection as a means of understanding oneself.Limitations of Introspective InsightSeminal work by Nisbett and Wilson demonstrated that individuals are frequently unaware of the true causes...