Positive expiratory pressure plateau: improved gas exchange during mechanical ventilation

Abstract

The effect of a positive expiratory pressure plateau (pepp) on gas exchange, cardiac output, and frc is examined in five patients in severe respiratory failure receiving artificial ventilation. Improvement in gas exchange for both oxygen and carbon dioxide without change in cardiac output is demonstrated in all cases. This is associated with an increase in resting lung volume. The mechanisms and therapeutic implication of these changes are discussed. It is suggested that this feature of the ventilatory wave form may be of considerable value in the management of severe hypoxia during respiratory failure. © 1969 Canadian Anesthesiologists.