UMEM Educational Pearls

Title: PEEP in the Intubated Obese Patient

Category: Critical Care

Posted: 12/8/2020 by Mike Winters, MBA, MD
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PEEP in the Intubated Obese Patient

Obesity has numerous adverse effects on the respiratory system, most notably a reduction in lung volumes.
The reduction in lung volumes (i.e., FRC) often result in airway closure and atelectasis.
The application of PEEP in the mechanically ventilated patient helps maintain alveolar patency by preventing derecruitment.
Importantly, the typical initial PEEP setting of 5 cm H2O is insufficient for many ventilated obese patients.
Pearl: In the ventilated obese patient start with an initial PEEP of 10-15 cm H2O.

De Jong A, et al. How to ventilate obese patients in the ICU. Intensive Care Med. 2020; 46:2423-35.