| Auto-PEEP in respiratory failure. | |
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MedLine Citation:
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PMID: 21971439 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Intrinsic positive end-expiratory pressure (auto-PEEP) is a common occurrence in patients with acute respiratory failure requiring mechanical ventilation. Auto-PEEP can cause severe respiratory and hemodynamic compromise. The presence of auto-PEEP should be suspected when airflow at end-exhalation is not zero. In patients receiving controlled mechanical ventilation, auto-PEEP can be estimated measuring the rise in airway pressure during an end-expiratory occlusion maneuver. In patients who trigger the ventilator or who are not connected to a ventilator, auto-PEEP can be estimated by simultaneous recordings of airflow and airway and esophageal pressure, respectively. The best technique to accurately measure auto-PEEP in patients who actively recruit their expiratory muscle remains controversial. Strategies that may reduce auto-PEEP include reduction of minute ventilation, use of small tidal volumes and prolongation of the time available for exhalation. In patients in whom auto-PEEP is caused by expiratory flow limitation, the application of low-levels of external PEEP can reduce dyspnea, reduce work of breathing, improve patient-ventilator interaction and cardiac function, all without worsening hyperinflation. Neurally adjusted ventilatory assist, a novel strategy of ventilatory assist, may improve patient-ventilator interaction in patients with auto-PEEP. |
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Authors:
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F Laghi; A Goyal |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-05 |
Journal Detail:
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Title: Minerva anestesiologica Volume: - ISSN: 1827-1596 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-10-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375272 Medline TA: Minerva Anestesiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Division of Pulmonary and Critical Care Medicine, Edward Hines Jr. Veterans Administration Hospital, Loyola University of Chicago Stritch School of Medicine, Hines, IL, USA - flaghi@lumc.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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