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Moreover, positive end-exploratory pressure (PEEP), particularly high levels, may promote venous stasis in the upper extremities by impeding venous return to the chest. Central venous pressure (CVP) increases along with increases in intrathoracic pressure, for example, with positive pressure ventilation or hyperinflation during mechanical ventilation. As a result, the pressure gradient for systemic venous return decreases, decelerating venous blood flow [7, 8]. Central venous pressure increases with PEEP in mechanically ventilated patients [8]. We, PI3K Inhibitor Library therefore, hypothesized that PEEP may be a risk factor for UEDVT. 2. Material and Methods We performed a retrospective case control study of medical ICU patients who required mechanical ventilation for >72 hours and underwent duplex ultrasound exams of their upper veins for suspected DVT between January 2011 and December 2013. The study (UFJ 2014-025) was approved by the Institutional Review Board Committee at the University of Florida in Jacksonville. The diagnosis of DVT was based on the visualization of an intravascular thrombus, incompressibility of the vein by probe pressure, absence of spontaneous flow Fossariinae by Doppler, and absence of variation in flow with respiration. The diagnosis of UEDVT required direct visualization of the thrombus and one or more of the other signs in the internal jugular, subclavian, axillary, brachiocephalic, or brachial veins. The central venous catheters (CVC) used at our institution are made of oligon material and heparin-coated. Catheter-related Sunitinib clinical trial UEDVT was defined as DVT in an upper extremity vein in which CVC or peripherally inserted catheter (PICC) was in place at the time of diagnosis or within the preceding 72 hours. We collected the following data: demographics, any known risk factors for venous thromboembolism (VTE), any use of prophylactic or therapeutic anticoagulation, duration of mechanical ventilation, and PEEP. We looked for the following known risk factors for DVT: malignancy, prior history of VTE, congestive heart failure (CHF), chronic obstructive pulmonary disease, other lung disease, atrial fibrillation, end-stage renal disease, sepsis, CVC or PICC, and morbid obesity. We looked for the possibility of an association between PEEP and UEDVT by examining the average PEEP over a period of 3 days and 7 days prior to venous duplex US exam and by comparing average PEEP