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"Auto-PEEP": incidence, magnitude, and contributing factors
1Department of Respiratory Therapy, University of California, Los Angeles Medical Center 90024-1658.
Heart & Lung : the Journal of Critical Care
|July 1, 1990
Summary
Auto-PEEP, or unintentional positive end-expiratory pressure, occurs in nearly half of mechanically ventilated patients. Monitoring for auto-PEEP is recommended due to its potential adverse effects and ventilator-related causes.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
Background:
- Unintentional positive end-expiratory pressure (auto-PEEP) can occur in patients on mechanical ventilation.
- Auto-PEEP may lead to adverse effects, including inaccurate hemodynamic data and cardiopulmonary complications.
Purpose of the Study:
- To determine the incidence and magnitude of auto-PEEP in a university hospital.
- To identify factors influencing the development of auto-PEEP in mechanically ventilated patients.
Main Methods:
- A 3-month prospective study evaluated patients on controlled mechanical ventilation in ICUs.
- Auto-PEEP was measured by occluding expiratory limb at end-expiration.
- Ventilator settings and patient parameters were recorded.
Main Results:
- Auto-PEEP was present in 47% of 57 patients, with levels ranging from 1 to 6 cm H2O.
- Incidence increased significantly with minute ventilation >18.4 L/min, respiratory rate >27 breaths/min, or set PEEP ≥10 cm H2O.
- Auto-PEEP is linked to ventilator-related factors.
Conclusions:
- Auto-PEEP is a common phenomenon in mechanically ventilated patients.
- Routine monitoring for auto-PEEP is advised in patients receiving controlled ventilation.
- Further research into the clinical impact of auto-PEEP is warranted.