MICU/SICU - HIGHEST PEEP you've seen?

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I had a patient the last 2 days on 25 of PEEP. The docs were concerned about her lungs

"popping," so for a while- we didn't move her. Finally, got it down to 15. What's the highest PEEP you've seen, and have you ever had a patient's lungs pop?

Specializes in SICU/MICU/CVICU/NEURO.

ARDS, doc had it at 30 for a day, but then again i wouldnt trust this pulmonologist to collect a sputum sample from me.

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Specializes in SICU.

PEEP of 28 on APRV, but APRV is "special" ;) We use it on all of our post op and trauma pt in our SICU. Works wonders for reducing volutrauma, but from the way I understand it, it is PEEP high... which is different that your classic PEEP. Even throws some expereinced RT's for a loop that haven't worked with it much. Enough so that they are developing an algorithm for vent settings and weaning parameters for the Hemod stable pt vs the Unstable ICU pt...

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Specializes in Telemetry, ICU, Psych.

I saw 25 in clincals a couple of months ago. ARDS at it's worst. 26 y/o with questionable aspiration pneumonia walked into the ER. He never made it out of the hospital.

CrazyPremed

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Specializes in SICU, NTICU.

Just recently. My pt had a PEEP of 20 with an open abd.

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Specializes in gen icu/ neuro icu/ trauma icu/hdu.

Have "walked Peep up to 35 cm H2O as part of recruitment manouver On pt with puritan bennet bilevel [hi peep lo peep]. Short term only however (couple min only) BP tends to go "bye bye" as pts tend to be a little vascularly dry and cant deal with the increased afterload and decreased preload due to the increased pressures.

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Specializes in CCU,MICU,SICU,CTICU,Renal, Recovery.

Vandy, was it a ct patient? Cabgs rountinely have 3. the last being for the pericardial space. Is it a patient with a hemothorax?

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