Positive end-expiratory pressure (PEEP) is the pressure in the lungs ( alveolar pressure) above atmospheric pressure (the pressure outside of the body) that exists at the end of expiration. [1] The two types of PEEP are extrinsic PEEP (PEEP applied by a ventilator) and intrinsic PEEP (PEEP caused by an incomplete exhalation). Pressure that is applied or increased during an inspiration is termed pressure support. PEEP is a therapeutic parameter set in the ventilator (extrinsic PEEP), or a complication of mechanical ventilation with air trapping (auto-PEEP). [2]
Auto-PEEP is an incomplete expiration prior to the initiation of the next breath causes progressive air trapping ( hyperinflation). This accumulation of air increases alveolar pressure at the end of expiration, which is referred to as auto-PEEP.
Auto-PEEP develops commonly in high minute ventilation ( hyperventilation), expiratory flow limitation (obstructed airway) and expiratory resistance (narrow airway).
Once auto-PEEP is identified, steps should be taken to stop or reduce the pressure build-up. [3] When auto-PEEP persists despite management of its underlying cause, applied PEEP may be helpful if the patient has an expiratory flow limitation (obstruction). [4] [5]
Applied PEEP is usually one of the first ventilator settings chosen when mechanical ventilation is initiated. It is set directly on the ventilator.
A small amount of applied PEEP (4 to 5 cmH2O) is used in most mechanically ventilated patients to mitigate end-expiratory alveolar collapse. [6] A higher level of applied PEEP (>5 cmH2O) is sometimes used to improve hypoxemia or reduce ventilator-associated lung injury in patients with acute lung injury, acute respiratory distress syndrome, or other types of hypoxemic respiratory failure. [7]
Positive end-expiratory pressure can contribute to:
John Scott Inkster, an English anaesthetist and physician, is credited with discovering PEEP. [11] When his discovery was published in the proceedings of the World Congress of Anaesthesia in 1968, Inkster called it Residual Positive Pressure.
Positive end-expiratory pressure (PEEP) is the pressure in the lungs ( alveolar pressure) above atmospheric pressure (the pressure outside of the body) that exists at the end of expiration. [1] The two types of PEEP are extrinsic PEEP (PEEP applied by a ventilator) and intrinsic PEEP (PEEP caused by an incomplete exhalation). Pressure that is applied or increased during an inspiration is termed pressure support. PEEP is a therapeutic parameter set in the ventilator (extrinsic PEEP), or a complication of mechanical ventilation with air trapping (auto-PEEP). [2]
Auto-PEEP is an incomplete expiration prior to the initiation of the next breath causes progressive air trapping ( hyperinflation). This accumulation of air increases alveolar pressure at the end of expiration, which is referred to as auto-PEEP.
Auto-PEEP develops commonly in high minute ventilation ( hyperventilation), expiratory flow limitation (obstructed airway) and expiratory resistance (narrow airway).
Once auto-PEEP is identified, steps should be taken to stop or reduce the pressure build-up. [3] When auto-PEEP persists despite management of its underlying cause, applied PEEP may be helpful if the patient has an expiratory flow limitation (obstruction). [4] [5]
Applied PEEP is usually one of the first ventilator settings chosen when mechanical ventilation is initiated. It is set directly on the ventilator.
A small amount of applied PEEP (4 to 5 cmH2O) is used in most mechanically ventilated patients to mitigate end-expiratory alveolar collapse. [6] A higher level of applied PEEP (>5 cmH2O) is sometimes used to improve hypoxemia or reduce ventilator-associated lung injury in patients with acute lung injury, acute respiratory distress syndrome, or other types of hypoxemic respiratory failure. [7]
Positive end-expiratory pressure can contribute to:
John Scott Inkster, an English anaesthetist and physician, is credited with discovering PEEP. [11] When his discovery was published in the proceedings of the World Congress of Anaesthesia in 1968, Inkster called it Residual Positive Pressure.