Putting PEEP in Perspective

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Abstract
Positive end-expiratory pressure (PEEP) was reported to be useful in the treatment of pulmonary edema in 1938,1 and its use has been widespread since Ashbaugh et al.2 reported that PEEP improved oxygenation in patients with the adult respiratory-distress syndrome. This form of acute lung injury is characterized by pulmonary edema due to increased permeability and by severe hypoxemia and decreased lung compliance. Mortality remains above 50 per cent,3 despite advances in supportive care and considerable research in the past two decades. The mechanism (or mechanisms) of lung injury in the adult respiratory-distress syndrome is nuclear. PEEP has been useful in . . .