Explanation of High PEEP

[Caty]

The last couple of nights, Nate's vent has alarmed High PEEP while he's been asleep. He has the LTV 1150 with internal PEEP and High PEEP is set at 12. His RT didn't seem too concerned when I called about it and told me to change it to 16.

What is typical High PEEP? His PEEP is set at 5 with Low PEEP turned off. I can see where PEEP would be high if he were playing or laughing, but asleep? Can the experts please explain?

Thanks!

[Alex's mom]

I wish I could help explain. I don't really understand it. We've always had the Hi peep alarm off. That was how it was set when we originally came home from the NICU. I think it used to continuously alarm.

[Jacob's Mom]

Hmm, I'm not sure what causes it either. We've always turned it off for the same reason though.

[Christamae]

My high peep is set very high. My muscles aare really weak and my diaphragm is tight so when I am asleep the vent really has to push hard to keep things open. When I have a lot of gas or I really have to pee the alarm will go off, too. If I am sick with a lot of tight secretions the vent will alarm, too.

[Mom2TwinsPlus1]

Our high peep only goes off if water is in the line. Ours is turned off right now, but when we had nursing we had to keep it set or our nurses would allow it to fill with water and high peep

[kshell]

Before, when Natalie would be on the vent during the day she would hold her breathe to make the high peep go off. Coughing sets it off too. Not sure with an internal peep what would make it go off.

Karen

[lil' G's mom]

I'm with Lori on this, we get high peep when there is excess water in the line, and also when G takes the lines and puts a kink in them, which he has learned will set the alarms off among the other ways he has figured out to do it, like blowing hard out of trach, ect.:D he just thinks it the greatest to make the alarms go off...

[TommysDad]

We usually see "HIGH PRESSURE" alarm going off if there's too much water in the line or if Tommy wants attention and holds his breath and then blows hard to make his vent "HIGH PRESSURE" alarm.

Tommy's dr's orders for vent settings were for PEEP of 12. His HIGH PEEP alarm was set to go off if the PEEP went to 17??? When Tommy's HIGH PEEP alarm goes off on his LTV 950, we know somethings not right. But usually his external PEEP valve gets so much water it gross! Usually I just shake all the water that's filling up the PEEP VALVE (not the circuit), and that takes care of that HIGH PEEP alarm. But you have that internal PEEP Valve right? So, that can't be it? Have you talked to your Pulmonologist to see as your child gets bigger and the lung cartlige stiffens, is the PEEP too much for the healthier lungs and causing the vent to be HIGH PEEP alarming? I know I wouldn't take an RT who just discredits an alarm to be my final word. I'd still want to hear it from my pulmonologist just to be safe. And hey, if it leads to a little vent weaning...all the better:D

Let us know what you hear! I'm very interested!

BTW...Tommy did just undergo some vent weaning. His PEEP went from 12 down to 8. We haven't seen that HIGH PEEP alarm go off which is still set at 17??? with the new PEEP setting. Is there a coorilation, I don't know!:confused:

[Christamae]

Oops-high pressure not high peep alarm...sorry!

[Caty]

I should have said PEEP is dialed in, not internal PEEP. We refer to things differently at home and I forget to do real-world translation. :rolleyes: His circuits do have the external PEEP valve and that does fill with water. He has a (non) sleep study coming up so we're not making any changes until then and we talk to the pulm. It hasn't alarmed again so we'll see. He does have a huge leak and that messes with other settings (Vte, sensitivty, etc.)...