Peak Inspiratory Pressure (PIP or Ppeak)

NORMAL PIP or Ppeak  (<35 cm H2O)
DEFINITION Highest (peak) proximal airway pressure reached during inspiration.
MECHANICS Keep PIP < 35 cm H2O
In VV – machine VT, VI, PEEP, and patient CLT and Raw determines PIP.
In PV – PIP is a set pressure limit; PIP + CLT + Raw = VT
↑ PIP → ↑ VT, Paw, and Palv (except in high Raw where the ↑ pressure is lost to the airway and may not reach the alveoli)
PIP is used to calculate Cdyn and Raw.
CAUTIONS PIP Precautions
Too low a PIP may result in hypoventilation and atelectasis.
Too high a PIP can increase the risk of barotrauma, compromise both ventilation and oxygenation effects, and significantly compromise hemodynamics.

Clinical Note
In VV, PIP is different than the pressure limit (P/L).  P/L is an inspiratory pressure limit that is set 5-10 cmH2O above PIP and acts as a safety mechanism that will immediately terminate TI.
In PV, PIP is a pressure limit that may vary or be set, depending on ventilator and/or mode