Which condition can PEEP potentially predispose patients to?

When utilizing Positive End-Expiratory Pressure (PEEP) in mechanical ventilation, one significant risk that clinicians must be aware of is the potential for barotrauma. PEEP works by increasing lung volume at the end of expiration, which enhances the recruitment of collapsed alveoli. While this can improve oxygenation and prevent atelectasis, excessive PEEP can lead to overdistension of the alveoli. This overdistension may increase the risk of alveolar rupture, which is known as barotrauma.

Barotrauma occurs when the pressure in the alveoli exceeds the capacity of the surrounding tissues, leading to air leaks into areas where it shouldn’t be, such as the pleural space or interstitial tissues. This condition can lead to serious complications, including pneumothorax, which can compromise respiratory function and necessitate further medical intervention.

In contrast, while PEEP can improve cardiac output indirectly in some cases by reducing the work of breathing and promoting better gas exchange, the potential for barotrauma is a tangible risk that requires careful monitoring. Increased lung compliance could be a beneficial effect of PEEP, but excessive use can counteract this benefit, leading to injury. Additionally, while PEEP is often used to reduce shunting by