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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.