A patient with ARDS has the slow pressure-volume loop shown below. Based on this loop, at what level should PEEP be set?
a. 10 cm H2O
b. 12 cm H2O
c. 18 cm H2O
d. 22 cm H2O
ANS: D
The rapid change in the slope of the deflation curve identifies the upper inflection point on the deflation portion of the curve as approximately 20 cm H2O. PEEP should be set 2-3 cm H2O above the upper inflection point, which is 22 cm H2O.
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