Re: Question about plateau pressures
There was no consensus.... The RT told me she would meet with me, but I could never catch up with her (She was days & I was nights). I left my job for a teaching post before I ever met up with her, but Dan's post above really helped me.
If I read his post correctly, I was right. Plateau pressures include PEEP and help to determine static compliance (which does not include peep). I could have interpreted his post incorrectly though.
What got me questioning teh issue is that peep is
end-expiratory (the lowest time of pressure in positive pressure ventilation). My thought is that set Peep never goes away unless we D/C it,
it is the minimum pressure. An inspiratory hold should not stop or negate PEEP, nor the pressure it causes. My thought is that inspiratory hold is
on top of peep.
Static compliance is wholly different. it involves plateau pressure minus peep. But, for protective lung ventilation, when our goal is for plateau pressures < 30, I truly feel this includes delivered peep (I acutally saw the pressure wave on the inspiratory hold starting at the level of set peep and then saw the RT subtract the peep--I still think subtracting peep calculates static compliance but not plateau pressures). I think this is a very important question since a great deal of evidence-based practice for ARDS relys on plateau pressures, and peep significangly affects this number.
I also realize I may be incorrect, but my logic just will not let it go....
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