AUTO-POSITIVE END-EXPIRATORY PRESSURE AND DYNAMIC HYPERINFLATION

Citation
Vm. Ranieri et al., AUTO-POSITIVE END-EXPIRATORY PRESSURE AND DYNAMIC HYPERINFLATION, Clinics in chest medicine, 17(3), 1996, pp. 379
Citations number
50
Categorie Soggetti
Respiratory System
Journal title
ISSN journal
02725231
Volume
17
Issue
3
Year of publication
1996
Database
ISI
SICI code
0272-5231(1996)17:3<379:AEPADH>2.0.ZU;2-6
Abstract
Deviation of end-expiratory lung volume from the elastic equilibrium v olume of the respiratory system is recognized as a cardinal feature in mechanically ventilated patients with severe chronic obstructive pulm onary disease (COPD) and acute asthma. The presence of dynamic hyperin flation implies that alveolar pressure remains positive throughout exp iration. At the end of the expiration, this positive difference betwee n alveolar and external airway pressures is termed auto-positive end-e xpiratory pressure (PEEP) or intrinsic-PEEP. The aims of this article are (1) to review the physiologic mechanisms of auto-PEEP and the use of PEEP in counterbalancing auto-PEEP and (2) to examine the clinical criteria for application of PEEP in patients with COPD.