Use of PEEP in acute respiratory distress syndrome in dogs.

This study evaluates the effectiveness of combining mechanical ventilation and 5 cm H2O positive end-expiratory pressure (PEEP) at the onset of adult respiratory distress syndrome (ARDS) in dogs. Five cm H2O PEEP applied at the onset of ARDS in oleic acid injured dogs resulted in a decrease in cardiac output (CO). This decrease was accompanied by beneficial effects including a relatively stable SaO2 and PaO2. Control group dogs (receiving mechanical ventilation only) showed a less dramatic changing in CO, but demonstrated a dramatic drop in saturation, compromising oxygen transport of the tissues. Thus, despite decrease in CO experienced by the PEEP group, oxygen extraction at the tissue level remained high.