ระดับแรงดัน Positive end-expiratory pressure ที่เหมาะสม ในผู้ป่วยที่มีภาวะหายใจลำบากเฉียบพลัน

pirun pukapong

Authors

pirun pukapong Ratchaburi Hospital

Keywords:

acute respiratory distress syndrome, optimal level of positive end-expiratory pressure

Abstract

Objective: To determine the optimal level of positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome (ARDS) and to compare 30-day mortality rates between different PEEP applications

Methods: This retrospective analytical study collected data over a one-year period, from November 1, 2024, to October 30, 2025. The study population included patients diagnosed with ARDS admitted to the Intensive Care Unit (ICU) at Ratchaburi Hospital. Data were retrieved from electronic medical records, including i-chart and HOSxP systems. Statistical analysis was performed using descriptive statistics; comparative analyses were conducted using independent t tests and chi-square tests (or Fisher’s exact test where appropriate).

Results: A total of 112 patients were included and divided into two groups: the High PEEP group (n = 43) and the Low PEEP group (n = 69). The 30-day mortality rate was 13.9% (6 out of 43) in the High PEEP group and 7.2% (5 out of 69) in the Low PEEP group. There was no statistically significant difference in mortality rates between the two groups. However, the High PEEP group showed a superior trend in the improvement of the PaO₂/FiO₂ ratio (P/F ratio) compared to the Low PEEP group.

Conclusion: In patients with ARDS, different levels of PEEP did not significantly affect 30-day mortality rates. Nevertheless, the application of high PEEP was more effective in improving blood oxygenation levels.

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