Impact of PEEP on lung mechanics and work of breathing in severe airflow obstruction

• DOI: 10.1152/jappl.1988.65.4.1488
• Publication Date: 2017-12-21T17:37:24Z
• Authors: T. C. Smith; J. J. Marini
• Keywords: Positive End-Expiratory Pressure; Work of breathing; Dynamic hyperinflation; Respiratory physiology; Airway obstruction; Pulmonary gas pressures

Positive end-expiratory pressure (PEEP) has generally been withheld from the treatment of patients with chronic airflow obstruction (CAO), in view risk hyperinflation and lack documented benefit. We studied 10 mechanically ventilated exacerbated CAO air trapping to determine impact PEEP on lung mechanics, alveolar pressure, work breathing. levels 5 cmH2O were applied whose pressures be positive when breathing against ambient (the auto-PEEP effect). All under two conditions: every breath machine assisted (AMV) controlled (paralyzed, CMV). improved expiratory resistance without substantially increasing peak static pressure. Inspiratory remained unchanged. The difference between values central airway narrowed as increased. Adding effective triggering sensitivity ventilator, diminished ventilatory drive, reduced mechanical during machine-assisted cycle. Our results indicate that low may improve mechanics reduce effort required severe obstruction, hazards hyperinflation.