Recent data in the literature suggest that effective pulmonary blood flow (Qp) measured invasively as cardiac output minus shunt flow, assumes its largest value at a PEEP level that is optimal in the sense that it also provides close to maximal oxygen delivery. Qp obtained noninvasively from simultaneous measurements of mixed expired and end-tidal CO2-concentrations is therefore proposed as a simple clinical indicator of the effects of PEEP on the cardio-pulmonary system. It is shown that modern respiratory equipment can be easily adapted to implement such a noninvasive evaluation of PEEP therapy. If the method is proven useful an automatic search for optimal PEEP becomes a future possibility.
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Andras Gedeon (1985) studied this question.
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