Work

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

Year: 2026

Type: article

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

Source: Journal of Perinatology

DOI: 10.1038/s41372-026-02579-z