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 V_T, V_I, PEEP, and patient C_LT and Raw determines PIP. In PV – PIP is a set pressure limit; PIP + C_LT + Raw = V_T↑ PIP → ↑ V_T, 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.
VENTILATION EFFECTS	↑ PIP (V_T) → ↓ PaCO₂
OXYGENATION	↑ PIP (Paw) → ↑ PaO₂
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 T_I. In PV, PIP is a pressure limit that may vary or be set, depending on ventilator and/or mode