![]() This is especially important for stiff lungs with low compliance. If a patient needs to clear CO2 by improving ventilation, he should receive some level of pressure support for his ventilation, either via BPAP or invasive ventilation.Įxtrinsic PEEP also significantly decreases the work of breathing. Nevertheless, extrinsic PEEP should never be used for the sole purpose of increasing ventilation. By opening up airways, the alveolar surface increases, creating more areas for gas exchange and somewhat improving ventilation. The application of extrinsic PEEP will, therefore, have a direct impact on oxygenation and an indirect impact on ventilation. The application of positive pressure inside the airways can open or “splint” airways that may otherwise be collapsed, decreasing atelectasis, improving alveolar ventilation, and, in turn, decreasing VQ mismatch. This, in turn, increases the solubility of oxygen and its ability to cross the alveolocapillary membrane and increase the oxygen content in the blood.Įxtrinsic PEEP also can be used to improve ventilation-perfusion (VQ) mismatches. This applies to mechanical or noninvasive ventilation in that increasing PEEP will increase the pressure in the system. By Henry’s law, the solubility of a gas in a liquid is directly proportional to the pressure of that gas above the surface of the solution. Extrinsic PEEP can be used to increase oxygenation.
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