Objective: This case study aims to explore the clinical application of Positive End-Expiratory Pressure (PEEP) in managing hypoxemic respiratory failure in a critically ill patient. The study emphasizes individualized titration of PEEP to optimize oxygenation while minimizing ventilator-induced lung injury.

Materials and Methods: A 46-year-old male presented with acute breathlessness and was diagnosed with hypoxemic respiratory failure. The patient was initially managed with Non-Invasive Ventilation (NIV) and later required invasive mechanical ventilation. Clinical assessment, radiological imaging, arterial blood gases (ABGs), and cardiac markers were used to guide interventions. The case involved continuous monitoring, escalation of antibiotics, cardiopulmonary support, and rigorous nursing care.

Results: Initial NIV support maintained adequate oxygenation (SpO₂ 94%), but due to deterioration on day 2, intubation was performed. After four days on mechanical ventilation with carefully set PEEP levels, oxygenation improved significantly (SpO₂ 97%). The patient was successfully extubated and transitioned through a step-down respiratory support strategy, including BiPAP and spirometry exercises. The nursing team ensured infection control, suctioning protocol adherence, ventilator management, and early mobilization. By day 7, the patient was discharged in a hemodynamically stable condition, and follow-up showed full recovery within a month.

Conclusion: The case underscores the significance of carefully titrated PEEP in treating hypoxemic respiratory failure. It highlights the importance of a multidisciplinary approach, particularly the role of critical care nurses in monitoring and supporting patients on mechanical ventilation. Through meticulous management and supportive care, including infection control and respiratory therapy, optimal outcomes can be achieved in acute respiratory distress settings.