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Asthma, Peak Pressures, and the Ventilator
- In previous pearls, we have highlighted ventilator settings for the asthmatic, along with the differences between peak and plateau pressure measurements.
- When ventilating the asthmatic, pay attention to the ventilator settings placed by your respiratory therapist.
- In general, the respiratory therapist will set the ventilator to stop delivering tidal volumes when the peak pressure exceeds 40-60 cm H2O.
- For asthmatics, this practice can result in very low tidal volumes.
- Thus, peak pressure limits must be set higher.
- As you know, high peak pressures have not been shown to be injurious, provided that the plateau pressure remains < 30 cm H2O
References
Manthous CA. Avoiding circulatory complications during endotracheal intubation and initiation of positive pressure ventilation. JEM 2010; 38:622-31.