Primary indications for using positive end expiratory pressure (PEEP) in conjunction with me-chanical ventilation include which of the following?
1. When dynamic hyperinflation occurs in chronic obstructive pulmonary disease (COPD) pa-tients.
2. When the imposed work of breathing is excessive.
3. When acute lung injury causes refractory hypoxemia.
a. 1 and 2 only
b. 1 and 3 only
c. 2 and 3 only
d. 1, 2, and 3
ANS: B
PEEP is used primarily to improve oxygenation in patients with refractory hypoxemia. PEEP may be indicated in the care of patients with COPD who have dynamic hyperinflation (auto-PEEP) during mechanical ventilatory support after other efforts to decrease auto-PEEP fail.
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