Guinness02
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Nothing beats a CXR to tell you how deep you are in the esophagus.
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Pulmonary Artery Occlusion Pressure, sorry.
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Plateau pressures are obtained by doing an inspiratory hold on the ventilator. When you do this the ventilator gives you the peak alveolar pressure. Ideally this number should be Respiratory distress becomes defined as ARDS when you have bilateral infiltrates on CXR, with a PaO2 to FiO2 ratio of Hope this helps.
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25 is the highest that you will see for the most part. To need to be on 25 of PEEP the pts lungs are usually very non-compliant because of ARDS, and the risk for barotrauma is high with these patients. I have seen pneumothoracis associated with PEEP settings this high because there Plateau Pressures are usually elevated also. To minimize the risk pneumothorax the use of low tidal volume strategies should be employed.