REBEL Core Cast 147.0–Ventilators Part 5: Key Mechanical Ventilator Pressures & Definitions Made Simple

Mechanical ventilation requires a nuanced understanding of pressure dynamics to minimize lung injury while supporting gas exchange. Peak inspiratory pressure (PIP) reflects total system resistance, whereas plateau pressure provides a more accurate estimate of alveolar pressure, which is critical for preventing barotrauma. Maintaining plateau pressure below 30 cm H2O and utilizing ideal body weight—rather than actual weight—to set tidal volumes between 6–8 mL/kg helps mitigate volutrauma. Furthermore, optimizing positive end-expiratory pressure (PEEP) reduces driving pressure (Delta P), preventing the repetitive collapse and re-inflation of alveoli known as atelectrauma. By minimizing these mechanical stressors, clinicians can reduce the inflammatory cascade associated with biotrauma, ultimately providing safer supportive care for patients with underlying respiratory pathologies.