ArticleRespiratory care2024
The Impact of Increased PEEP on Hemodynamics, Respiratory Mechanics, and Oxygenation in Pediatric ARDS.
Article in Respiratory care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Effect of driving pressure-guided individualized PEEP in children undergoing right lateral thoracotomy cardiac surgery with cardiopulmonary bypass on postoperative atelectasis and oxygenation: a randomized controlled trial.BMC anesthesiology · 2026Trial
- Effects of individualized PEEP titration on intraoperative cardiac output in thoracoscopic lung surgery: a prospective randomized trial.Scientific reports · 2026Trial
- Recent updates regarding the management and treatment of pneumonia in pediatric patients: a comprehensive review.Infection · 2025Review
- Positive end-expiratory pressure impact on cardiac output and cerebral hemodynamics in newborns.European journal of pediatrics · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPEEP is a cornerstone treatment for children with pediatric ARDS. Unfortunately, its titration is often performed solely by evaluating oxygen saturation, which can lead to inadequate PEEP level settings and consequent adverse effects. This study aimed to assess the impact of increasing PEEP on hemodynamics, respiratory system mechanics, and oxygenation in children with ARDS.
methodsChildren receiving mechanical ventilation and on pressure-controlled volume-guaranteed mode were prospectively assessed for inclusion. PEEP was sequentially changed to 5, 12, 10, 8 cm H
resultsA total of 31 subjects were included, with median age and weight of 6 months and 6.3 kg, respectively. The main reasons for pediatric ICU admission were respiratory failure caused by acute viral bronchiolitis (45%) and community-acquired pneumonia (32%). Most subjects had mild or moderate ARDS (45% and 42%, respectively), with a median (interquartile range) oxygenation index of 8.4 (5.8-12.7). Oxygen saturation improved significantly when PEEP was increased. However, although no significant changes in blood pressure were observed, the median cardiac index at PEEP of 12 cm H
conclusionsAlthough it may improve arterial oxygen saturation, inappropriately high PEEP levels may reduce cardiac output, oxygen delivery, and respiratory system compliance in pediatric subjects with ARDS with low potential for lung recruitability.
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