PEEP & CPAP (Exam 1) Study Guide.

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PEEP & CPAP (Exam 1) Study Guide.


PEEP - answer✔recruits a certain number of collapsed alveoli


increases FRC & increases compliance in the dependent are (lower lobe) of lung

*compliance decreases in the non-dependent (upper lobe) area of the lung due to overdistention


Indications of PEEP - answer✔Refractory Hypoxemia (will not respond to supplemental O2)


Shunt of >30%

Atelectasis with decreased FRC

decreased compliance

Certain disease processes


Goals of PEEP - answer✔enhance tissue oxygenation


maintain PaO2 >60 & SpO2 at or >90% @ acceptable pH

Recruit alveoli & maintain

Restore FRC


Initiating PEEP - answer✔FIO2 >.50


PIP >35 cwp

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is PaO2 still <60: then start to increase PEEP by 3-5 until:

1. acceptable oxygenation achieved

2. unacceptable side effects occur:

decreased compliance

decreased cardiac function

barotrauma


Levels of PEEP - answer✔Minimum "physiologic" 3-5


moderate 5-15

maximum >15

Optimal - PEEP level which achieves maximum benefits with least side effects


Physiologic Effects of PEEP on: - answer✔PaO2 - up


FRC - up

PaCO2 - down

BP - down

PvO2 - improves

Intrapulmonary shunt - down

Cardiac output - down