Abstract
The issue of “the best PEEP (positive end-expiratory pressure)” in acute respiratory failure remains highly contoversial. Many intensivists are confused how to optimize PEEP. We reviewed the effects of PEEP on cardiorespiratory systems, pulmonary surfactant and cytokines, and pulmonary morphology. To find out the best PEEP, we discussed minimal PEEP, PEEP for maximizing oxygen delivery, PEEP for preventing ventilator-associated lung injury (VALI), and PEEP for reducing respiratory work load. There is no definite criterion to identify the best PEEP. To identify the best PEEP, further studies are required.
