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Objective <p>Establish the feasibility of optimizing PEEP (PEEP<sub>OPT</sub>) using ventilator software in infants receiving prolonged invasive mechanical ventilation.</p> Methods <p>A retrospective review of infants who underwent PEEP<sub>OPT</sub> studies. Paired-t test was used to compare dynamic lung compliance (Cdyn), tidal volume (VT), and oxygen saturation (SpO<sub>2</sub>) before and after PEEP<sub>OPT</sub> studies.</p> Results <p>Fifteen infants with bronchopulmonary dysplasia and/or receiving prolonged invasive mechanical ventilation were included with a median gestational age of 24 4/7 weeks and postmenstrual age of 40 1/7 weeks at the time of the PEEP<sub>OPT</sub> study. PEEP<sub>OPT</sub> was different from clinically set PEEP (PEEP<sub>SET</sub>) in 14/15 infants; PEEP<sub>OPT</sub> was higher in 27% and lower in 67% of infants (–2 to +5cmH<sub>2</sub>O). Cdyn improved for most infants by 0.23 (0.01–0.60) mL/H<sub>2</sub>O (<i>p</i> &lt; 0.001). VT increased for most infants by 1.5 (–0.5 to 3.4) mL/kg (<i>p</i> &lt; 0.001), and SpO<sub>2</sub> increased by 2% (–1 to 12%).</p> Conclusion <p>Assessment of PEEP<sub>OPT</sub> using our standardized protocol is feasible, non-invasive, and provides a low-cost bedside tool. PEEP<sub>OPT</sub> differed from PEEP<sub>SET</sub> in most subjects, highlighting the importance of evaluating PEEP<sub>OPT</sub>.</p>

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A non-invasive diagnostic tool for the assessment of optimal positive-end expiratory pressure (PEEPOPT) in infants receiving prolonged invasive ventilation

  • 期刊论文

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  • 发表日期：

    2026年2月16日

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  • Nada Darwish,
  • Ann Donnelly,
  • Jennifer Erkinger,
  • Shaoyi Zhang,
  • Dajiang Liu,
  • Jeffrey R. Kaiser,
  • Roopa Siddaiah

摘要

Objective

Establish the feasibility of optimizing PEEP (PEEPOPT) using ventilator software in infants receiving prolonged invasive mechanical ventilation.

Methods

A retrospective review of infants who underwent PEEPOPT studies. Paired-t test was used to compare dynamic lung compliance (Cdyn), tidal volume (VT), and oxygen saturation (SpO2) before and after PEEPOPT studies.

Results

Fifteen infants with bronchopulmonary dysplasia and/or receiving prolonged invasive mechanical ventilation were included with a median gestational age of 24 4/7 weeks and postmenstrual age of 40 1/7 weeks at the time of the PEEPOPT study. PEEPOPT was different from clinically set PEEP (PEEPSET) in 14/15 infants; PEEPOPT was higher in 27% and lower in 67% of infants (–2 to +5cmH2O). Cdyn improved for most infants by 0.23 (0.01–0.60) mL/H2O (p < 0.001). VT increased for most infants by 1.5 (–0.5 to 3.4) mL/kg (p < 0.001), and SpO2 increased by 2% (–1 to 12%).

Conclusion

Assessment of PEEPOPT using our standardized protocol is feasible, non-invasive, and provides a low-cost bedside tool. PEEPOPT differed from PEEPSET in most subjects, highlighting the importance of evaluating PEEPOPT.