PEEP: Effect on PAOP

Positive end-expiratory pressure will increase intrathoracic pressure, leading to:

• decreased venous return
• increased RV afterload
• decreased ventricular compliance
• decreased ventricular contractility

PEEP will decrease cardiac output in hypovolemic and normovolemic patients because of the drop in venous return.

If a patient has poor LVEF or CHF, PEEP will reduce LV transmural pressure, reducing afterload, which improves LV function. PAOP will also be reduced.