Which type of pressure in mechanical ventilation increases the risk of barotrauma?

Plateau pressure is the type of pressure measured during mechanical ventilation that reflects the pressure needed to maintain inflation of the lung's alveoli and is taken when airflow is momentarily stopped. This measurement is crucial since it provides an estimate of the pressure within the alveoli, distinguishing it from pressures related to airflow resistance in the endotracheal tube or the airway.

High plateau pressures indicate that the lungs may be overly distended, potentially leading to over-inflation of the alveoli. When alveoli are over-distended, the risk of rupture increases, leading to barotrauma, which is a serious complication characterized by air escaping into the thoracic cavity. This pressure can rise due to decreased lung compliance, which may be caused by various lung pathologies such as acute respiratory distress syndrome (ARDS) or pulmonary edema.

In examining the other options, peak pressure is related to the maximum pressure reached during inspiration and includes resistance factors, while mean airway pressure averages pressures during the entire respiratory cycle but does not specifically indicate alveolar distension. Auto-PEEP, on the other hand, refers to air trapping in the lungs that can lead to increased end-expiratory lung volume but does not directly correlate with alveolar rupture risks as plateau pressure does.