Is This a Patient Who Needs Too Much Peep?

A patient who really needs that much peep should have a horribly consolidated lung. They should have airspace disease as incredibly dense throughout both lungs in essentially every field. It should look like somebody spilled an entire box of cotton balls on the front of their chest before the x-ray. If you see a lung that has pretty nice architecture and a lot of really nicely aerated lung, you should ask, is this patient just being over peeped? Who knows how or why we got to this point? But at this particular stage, they don't need this many peeps.