Question

The following data are gathered during a PEEP study (FIO2 = 0.60). Based on these data, what is the optimum PEEP level?

PEEP cm H2O
0, 5, 10, 15, 20, 25
PaO2 mm Hg
46, 54, 67, 73, 75, 74
Compliance ml/cm H2O
18, 23, 26, 30, 24, 19
Systolic pressure
125, 123, 114, 115, 104, 94
Diastolic pressure
90, 88, 83, 84, 76, 68
a.10 cm H2O
b.15 cm H2O
c.20 cm H2O
d.25 cm H2O

Answer 1

Based on the data provided, with a peak in PaO2 and good compliance without significant loss in systolic pressure, the optimum PEEP level is 15 cm H2O.

Step-by-step explanation:

The optimum PEEP (Positive End-Expiratory Pressure) level aims to provide the highest PaO2 without causing significant hemodynamic compromise or decreased compliance. From the provided data, the PaO2 increases with each increment of PEEP until it plateaus at 20 cm H2O; however, beyond 15 cm H2O, the compliance starts to decrease, and the systolic pressure also begins to fall significantly after this point. Therefore, the optimum PEEP level would be where PaO2 is reasonably high, compliance is not significantly reduced, and systolic pressure is not critically lowered. This balance seems to occur at 15 cm H2O, which is the optimum PEEP in this case.