What is the initial setting for PEEP for an infant with no prior information?

The initial setting for Positive End-Expiratory Pressure (PEEP) in an infant typically falls within the range of 2 to 4 cmH2O. This value is often utilized for various reasons related to the physiological characteristics of infants and their respiratory support needs.

In neonates and infants, the lungs are still developing, and they may have less lung volume and compliance compared to adults. A lower level of PEEP helps to maintain alveolar recruitment and improve oxygenation, while minimizing the risk of over-distension or barotrauma to the fragile lung tissue. Setting the PEEP too high initially could cause potential harm, including reduced hemodynamics due to decreased venous return or impaired ventilation-perfusion matching.

Moreover, starting with a moderate level like 2 to 4 cmH2O allows for the assessment of the infant's response to ventilation and enables clinicians to adjust the settings based on the infant’s specific conditions or changes in their clinical status. This gradual approach promotes safe and effective ventilation outcomes without overwhelming the delicate respiratory system of a newborn.