The therapist was titrating PEEP levels to maintain an SaO₂ of 85% and found that 13 cm H₂O were required to achieve this goal. What should be the most important concern with this level of PEEP?

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PEEP is typically increased to a level that allows adequate oxygenation as defined by an arterial oxygen saturation (SaO₂) of 85% or greater at an acceptable FiO₂ of 0.60 or less. It should be noted that the minimal acceptable arterial oxygen saturation remains very controversial. A PEEP level of 10 to 15 cm H₂O, or even higher, may be required to achieve adequate oxygenation. However, as PEEP levels exceed from 12 to 15 cm H₂O, the increase in intrathoracic pressure may adversely affect cardiac output, primarily by decreasing systemic venous return. As PEEP is increased, the ARDS patient should be monitored for a decrease in cardiac output with a decrease in peripheral perfusion.

The Therapist Was Titrating PEEP Levels to Maintain an SaO2

The Therapist Was Titrating PEEP Levels to Maintain an SaO₂