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Hypotension during a PEEP (Positive End-Expiratory Pressure) maneuver in a donor can arise due to the increased pressure to the superior vena cava. When PEEP is applied, it increases intrathoracic pressure, which can compress the heart and great vessels, including the superior vena cava. This compression can impede venous return to the heart, decreasing preload and ultimately leading to lower cardiac output and hypotension.

In situations involving donors, maintaining adequate hemodynamic stability is crucial, and any factor that increases intrathoracic pressure can significantly influence cardiovascular dynamics. The role of PEEP is particularly relevant in this context, as while it can improve oxygenation and lung mechanics, the adverse hemodynamic effects from increased pressures can complicate the overall management of the donor. Therefore, the association between PEEP-induced intrathoracic pressure changes and hypotension is an essential consideration for transplant nurses managing donors during these procedures.