What is the typical PEEP or CPAP target in initial infant ventilation?

• A. PEEP 0-2
• B. PEEP 2-4 or match CPAP
• C. PEEP 6-8
• D. No PEEP

Answer: (B)

Maintaining a positive end-expiratory pressure helps keep the newborn’s alveoli open at the end of each breath, preserving functional residual capacity and improving oxygenation without overdistending the lungs. For initial ventilation, a modest PEEP of 2–4 cm H2O provides enough recruitment to prevent collapse but minimizes risks like decreased venous return or barotrauma. If you’re using CPAP instead of a ventilator with PEEP, set the CPAP level to the same target (2–4 cm H2O).

A lower setting (0–2 cm H2O) would allow rapid alveolar collapse and worse gas exchange, while a higher setting (6–8 cm H2O) increases the risk of overdistention, reduced venous return, and potential pneumothorax.