Positive end-expiratory pressure
pressure in the lungs above atmospheric pressure that exists at the end of expiration
Positive end-expiratory pressure (PEEP) is the pressure in the lungs (alveolar pressure) above atmospheric pressure (the pressure outside of the body) that exists at the end of expiration. The two types of PEEP are extrinsic PEEP (applied by a ventilator) and intrinsic PEEP (caused by an incomplete exhalation). Pressure that is applied or increased during an inspiration is termed pressure support. PEEP is a therapeutic parameter set in the ventilator (extrinsic PEEP), or a complication of mechanical ventilation with air trapping (auto-PEEP).
Intrinsic (auto-) PEEP
Auto-PEEP is an incomplete expiration prior to the initiation of the next breath causes progressive air trapping (hyperinflation). This accumulation of air increases alveolar pressure at the end of expiration, which is referred to as auto-PEEP.
Auto-PEEP develops commonly in high minute ventilation (hyperventilation), expiratory flow limitation (obstructed airway) and expiratory resistance (narrow airway).
Once auto-PEEP is identified, steps should be taken to stop or reduce the pressure build-up. When auto-PEEP persists despite management of its underlying cause, applied PEEP may be helpful if the patient has an expiratory flow limitation (obstruction).
Extrinsic (applied) PEEP
Applied PEEP is usually one of the first ventilator settings chosen when mechanical ventilation is initiated. It is set directly on the ventilator.
The public source identifies “Positive end-expiratory pressure” as pressure in the lungs above atmospheric pressure that exists at the end of expiration. This brief keeps that definition visible, then builds a research path around Positive, end-expiratory and pressure.
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This entry incorporates text from “Positive end-expiratory pressure” on English Wikipedia. Contributors are listed in the page history. Text is available under the Creative Commons Attribution-ShareAlike 4.0 License. Selected authority identifiers and statements are retrieved from Wikidata under CC0; their references and qualifiers remain part of the verification path.