[Aspects of primary PEEP ventilation for immediate treatment of emergency patients (author's transl)].
PEEP ventilation is frequently used in intensive care patients: its particular effects in the immediate treatment of emergency patients are discussed. In animal experiments different studies were performed using manually operated resuscitators combined with a newly designed PEEP valve. The most important results in neonatal pigs show that the post partum compliances and the neonatal PO2 values were much better after primary PEEP ventilation than after IPPB or 2-phases unfolding inflation. The worst method of respiratory resuscitation is the use of PNPB. In 2 other groups of animals immediate PEEP ventilation was compared to IPPB, after 25 ml of fresh water/kg BW had been instilled into the animals lungs. The PaO2 and AaDO2 values of those animals, treated immediately with PEEP were much better than the corresponding values of the ZEEP group animals. But, the PEEP-treated animals showed a significant reduction of the cardiac output. The article deals further with the results of different authors, as far as PEEP and lung edema, PEEP and CPR, PEEP and shock are concerned. In our opinion, the present clinical and experimental results lead to the following conclusions: The immediate PEEP ventilation at the scene is indicated 1. in neonatal resuscitation - 2. in near drowning - 3. in lung edema - 4. in cardiopulmonary resuscitation. PEEP ventilation should however not exceed 10 cm H2O.