Therapeutic use of intrinsic positive end-expiratory pressure

A patient with acute hypoxemic respiratory failure undergoing mechanical ventilation with PEEP developed significant obstructive airway disease. We found that intrinsic PEEP, substituted for externally applied PEEP, could maintain oxygenation. The increased inspiratory/expiratory time ratio, which resulted in the development of intrinsic PEEP, beneficially reduced airway pressures.