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 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 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