We usually think of peep being associated with oxygenation, but doesn,t it play a big role in improving ventilation? Where I work the docs think of peep only when po2/spo2's are low and the patient is on high fio2. I have been recently educated, ,with the help of Light, as to the importance of peep with regards to FRC. Our docs thinking currently is to decrease peep to +5 has fast as possible, but we ventilate at an average of 10ml/kg ibw. I am thinking starting peep should be +10 at 10ml/kg ibw. Our medical director stated that peep was not a topic at the 06 chest conference. He also stated that if I can find evidence based data, he may change his way of thinking. My goal is to work towards increased peep with conventional ventilation and using APRV.
