Dynamic pulmonary hyperinflation and intrinsic PEEP: consequences and management in patients with chronic obstructive pulmonary disease.
The presence of dynamic hyperinflation and intrinsic PEEP is a common and yet too often unrecognized occurrence in patients with airway obstruction both in stable state and during acute exacerbations. Intrinsic PEEP may represent an important load on the inspiratory muscles which are operating at a mechanical disadvantage due to hyperinflation. This may contribute significantly to ventilatory failure. The presence of intrinsic PEEP also has other important clinical ramifications. Prompt recognition of intrinsic PEEP will allow for proper measurement and interpretation of a variety of cardiopulmonary parameters and improved clinical decision making and management of these critically ill patients.
Milic-Emili
J
J
Meakins-Christie Laboratories, McGill University, Montreal.
D000208:Acute Disease; D002245:Carbon Dioxide / Q000502:physiology; D005652:Functional Residual Capacity / Q000502:physiology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D010313:Partial Pressure; D011175:Positive-Pressure Respiration; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D015656:Respiratory Mechanics / Q000502:physiology; D014939:Work of Breathing / Q000502:physiology
D002245:Carbon Dioxide