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PEEP Reference

Positive End-Expiratory Pressure (PEEP) maintains alveolar recruitment and prevents atelectasis. The ARDSNet protocol provides FiO2/PEEP tables as a guideline for titration.

PEEP Lookup

ARDSNet PEEP/FiO2 Table

FiO2Lower PEEP (cmH2O)Higher PEEP (cmH2O)
0.3055
0.405-88
0.508-1010
0.601010
0.7010-1412
0.801414
0.9014-1814-18
1.0018-2418-24

PEEP Guidelines

Baseline: 5 cmH2O is the standard starting PEEP for most patients.

Neonates: PEEP of 4-6 cmH2O is commonly used. Higher PEEP (6-8 cmH2O) may be appropriate for severe RDS.

Titration: Increase PEEP in increments of 1-2 cmH2O based on oxygenation response and hemodynamic stability.

Monitoring: Watch for overdistension, decreased cardiac output, and air leak syndrome with high PEEP settings.

References

  • ARDS Network. Ventilation with Lower Tidal Volumes. NEJM 2000;342:1301-8.
  • Walsh BK. Neonatal and Pediatric Respiratory Care, 5th Edition.