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Peak pressure applies when there is airflow in the circuit, i.e. during inspiration. What determines
the peak pressure is the airway resistance in the lungs. So it follows that if there is a problem with
the airways the peak pressure will rise.
Plateau Pressure
Plateau pressure applies when there is not airflow in the circuit. That is when inspiration is
complete. This pressure is determined by the lung compliance. So it follows that if there is a
problem with the compliance the plateau pressure will rise.
So lets work through this diagram to help our understanding of the difference, and how it
can help us interpret the information.
So, remember, peak pressure (circled) is a reflection of the airways and plateau pressure is a
reflection of lung compliance.
Remembering that important fact, lets look at a couple of examples that we might
encounter.
Bronchospasm
Retained secretions
Mucous plug
ETT tip occlusion
Pneumothorax
Pulmonary oedema
ARDS
Pneumonia.
So understanding the difference between peak pressure and plateau pressure will help you
diagnose what may be wrong with your patients ventilation.