Document Detail

Measurement of air trapping, intrinsic positive end-expiratory pressure, and dynamic hyperinflation in mechanically ventilated patients.
MedLine Citation:
PMID:  15636649     Owner:  NLM     Status:  MEDLINE    
Severe airflow obstruction is a common cause of acute respiratory failure. Dynamic hyperinflation affects tidal ventilation, increases airways resistance, and causes intrinsic positive end-expiratory pressure (auto-PEEP). Most patients with asthma and chronic obstructive pulmonary disease have dynamic hyperinflation and auto-PEEP during mechanical ventilation, which can cause hemodynamic compromise and barotrauma. Auto-PEEP can be identified in passively breathing patients by observation of real-time ventilator flow and pressure graphics. In spontaneously breathing patients, auto-PEEP is measured by simultaneous recordings of esophageal and flow waveforms. The ventilatory pattern should be directed toward minimizing dynamic hyperinflation and auto-PEEP by using small tidal volume and preserving expiratory time. With a spontaneously breathing patient, to reduce the work of breathing and improve patient-ventilator interaction, it is crucial to set an adequate inspiratory flow, inspiratory time, trigger sensitivity, and ventilator-applied PEEP. Ventilator graphics are invaluable for monitoring and treatment decisions at the bedside.
Lluís Blanch; Francesca Bernabé; Umberto Lucangelo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Respiratory care     Volume:  50     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-07     Completed Date:  2005-04-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  110-23; discussion 123-4     Citation Subset:  IM    
Critical Care Center, Hospital de Sadabell, Institut Universitari Fundaciò Parc Taulì, Corporaciò Parc Taulì, Universitad Autònoma de Barcelona, Sadabell, Spain.
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MeSH Terms
Airway Obstruction / therapy*
Asthma / physiopathology
Positive-Pressure Respiration / adverse effects*
Positive-Pressure Respiration, Intrinsic / physiopathology*,  therapy
Pulmonary Disease, Chronic Obstructive / physiopathology
Respiration, Artificial / methods
Respiratory Distress Syndrome, Adult / therapy
Work of Breathing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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