What is the recommended initial setting for PEEP when delivering NIV in a pressure-triggered mode?

The recommended initial setting for PEEP (Positive End-Expiratory Pressure) when delivering Noninvasive Ventilation (NIV) in a pressure-triggered mode is typically established at 5 - 8 cm H2O. This range is appropriate because it effectively prevents alveolar collapse at the end of expiration, thus improving oxygenation and ventilation.

Setting PEEP within this range helps to maintain functional residual capacity, which is crucial for patients who may experience atelectasis or have lung compliance issues. Additionally, it facilitates better gas exchange by recruiting collapsed or under-ventilated lung units, without causing excessive pressure which could lead to discomfort for the patient or possible hemodynamic compromise.

This approach also allows for further adjustments based on the patient's response, ensuring that optimal levels of support are provided. Higher settings could introduce risks such as decreased cardiac output or impaired hemodynamics, which are important considerations in the management of patients requiring NIV.