During the application of positive-end-expiratory pressure (PEEP),the monitoring of which pressure will alert the respiratory therapist specifically to alveolar overdistention?

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The plateau pressure (P_plateau)is the pressure required to overcome only elastance.When positive-end-expiratory pressure (PEEP)is applied,the alveolar pressure will rise.This will result in a higher P_plateau.If overdistention occurs the P_plateau will rise immediately.Peak inspiratory pressure (PIP)reflects the total force that must be applied to overcome both elastance and airway resistance offered by the patient-ventilator system.The mean airway pressure represents the average pressure recorded during the entire respiratory cycle.It is influenced by PIP,PEEP,inspiratory time and total cycle time.The mean airway pressure is not a specific monitor for optimizing PEEP.The PIP will increase in the face of alveolar overdistention,but it is not specific enough to rely on as the sole measurement to identify overdistention.The transairway pressure is the difference between the PIP and the P_plateau,and represents the amount of pressure needed to overcome airway resistance (all frictional forces).The transairway pressure will not reflect alveolar overdistention because when alveolar overdistention happens both the PIP and the P_plateau will rise,and the difference between the two will remain constant unless there is an unrelated change in airway resistance.

During the Application of Positive-End-Expiratory Pressure (PEEP),the Monitoring of Which