Table of ContentsView AllTable of ContentsDefinition of PEEPHow It WorksHow It’s UsedPrecautions

Table of ContentsView All

View All

Table of Contents

Definition of PEEP

How It Works

How It’s Used

Precautions

Any of these causes can be serious enough to requireintubation. In this procedure, a breathing tube is inserted in the mouth or nose and down thetrachea(windpipe). The tube is connected to a machine to assist with breathing and ensure the blood is getting enoughoxygen.

This article will explain what positive end-expiratory pressure is, how it works, when it is used, and the precautions that a healthcare provider will consider before recommending PEEP.

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Close up of doctor wearing surgical gloves, holding oxygen mask over patient in operating theater

Acute Respiratory Distress Syndrome (ARDS): What to Know

Definition of Positive End-Expiratory Pressure

Alveoli are small air spaces in the lungs where the exchange of oxygen and carbon dioxide (ventilation) occurs.When a person breathes normally, the lungs allow for the airways and alveoli to remain open. This occurs because a substance called a surfactant prevents alveoli from collapsing, allowing for proper oxygen exchange.

However, if the body’s production of surfactants is interrupted, the lack of available surfactants causes the alveoli to collapse, leading to inadequate oxygen exchange.This is when mechanical ventilation is required.

PEEP is a function of mechanical ventilation that maintains pressure throughout the airways and alveoli to allow for oxygen exchange while giving the lungs the chance to heal.

PEEP is available on most mechanical ventilators and is used for intubated people who require a machine to help them breathe and distribute oxygen to the blood.It is a ventilator setting designed to keep the smaller passages of the lungs, such as the alveoli, open during theexpiratory, or breathing-out, phase.

PEEP is different from continuous positive airway pressure (CPAP), which is positive external pressure continuously administered through a face mask.CPAP mainly is used for people who have been diagnosed withobstructive sleep apneaand is designed to keep the windpipe open during sleep. PEEP works much further into the lungs than CPAP.

PEEP is used when a person needs mechanical ventilation because they are unable to breathe on their own. Healthcare providers often refer to this as acuterespiratory failure. Common causes of acute respiratory failure include:

Depending on the severity of the respiratory failure, a person may need to be intubated and placed on a ventilator to distribute oxygen from the lungs to the blood while allowing the lungs to rest and heal.

PEEP can effectively manage acute respiratory failure and otherlung conditionsrequiring breathing support. Keeping the airways and alveoli open is crucial for proper blood oxygenation and lung healing.

Complications of PEEP include:

Summary

Positive end-expiratory pressure (PEEP) keeps the airways and small lung spaces open to allow for adequate oxygenation when a person cannot breathe on their own. If the lungs cannot oxygenate properly, the individual may need to be intubated and placed on mechanical ventilation to allow the lungs time to heal. PEEP is a function of the mechanical ventilator that uses pressure to keep the airways and alveoli open to allow for proper oxygen exchange.

A Word From Verywell

7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gattinoni L, Collino F, Maiolo G, et al.Positive end-expiratory pressure: how to set it at the individual level.Ann Transl Med. 2017;5(14):288. doi:10.21037/atm.2017.06.64American Lung Association.ARDS treatment and recovery.UpToDate.Positive end-expiratory pressure (PEEP).NIH National Cancer Institute.Alveoli.The Critical Care Practitioner.Mechanical ventilation- PEEP (positive end expiratory pressure).Mora Carpio AL, Mora JI.Positive end-expiratory pressure. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.NIH National Heart, Lung, and Blood Institute.Respiratory failure.

7 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gattinoni L, Collino F, Maiolo G, et al.Positive end-expiratory pressure: how to set it at the individual level.Ann Transl Med. 2017;5(14):288. doi:10.21037/atm.2017.06.64American Lung Association.ARDS treatment and recovery.UpToDate.Positive end-expiratory pressure (PEEP).NIH National Cancer Institute.Alveoli.The Critical Care Practitioner.Mechanical ventilation- PEEP (positive end expiratory pressure).Mora Carpio AL, Mora JI.Positive end-expiratory pressure. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.NIH National Heart, Lung, and Blood Institute.Respiratory failure.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Gattinoni L, Collino F, Maiolo G, et al.Positive end-expiratory pressure: how to set it at the individual level.Ann Transl Med. 2017;5(14):288. doi:10.21037/atm.2017.06.64American Lung Association.ARDS treatment and recovery.UpToDate.Positive end-expiratory pressure (PEEP).NIH National Cancer Institute.Alveoli.The Critical Care Practitioner.Mechanical ventilation- PEEP (positive end expiratory pressure).Mora Carpio AL, Mora JI.Positive end-expiratory pressure. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.NIH National Heart, Lung, and Blood Institute.Respiratory failure.

Gattinoni L, Collino F, Maiolo G, et al.Positive end-expiratory pressure: how to set it at the individual level.Ann Transl Med. 2017;5(14):288. doi:10.21037/atm.2017.06.64

American Lung Association.ARDS treatment and recovery.

UpToDate.Positive end-expiratory pressure (PEEP).

NIH National Cancer Institute.Alveoli.

The Critical Care Practitioner.Mechanical ventilation- PEEP (positive end expiratory pressure).

Mora Carpio AL, Mora JI.Positive end-expiratory pressure. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

NIH National Heart, Lung, and Blood Institute.Respiratory failure.

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