Assessment of Factors Related to Auto-PEEP

Compensating Artificial Airway Resistance via Active Expiration Assistance

“…9 Factors for increased risk of intrinsic PEEP are flow limitation, ventilation settings, and resistance of the respiratory system. 3 The tracheal tube as the narrowest part of the respiratory system determines predominantly the resistance of the artificial airways. 4 In studies in physical models, the influence of the tracheal tube's ID on the risk of PEEPi and the benefit of compensating for the tube's resistance were well documented, 2 and the use of large bore tubes was recommended to prevent PEEPi.…”

“…As a consequence, the risk of incomplete expiration and the resulting intrinsic PEEP (PEEPi) is increased accordingly. [2][3][4][5] An emergency ventilation system (Ventrain, Dolphys Medical, Eindhoven, The Netherlands) that ensures a sufficient respiratory minute volume via needle cricothyrotomy has been developed. 6 This system is based on the manual control of an approximately constant flow during inspiration and expiration.…”

Flow‐controlled ventilation improves gas exchange in lung‐healthy patients— a randomized interventional cross‐over study

“…Despite the short application, positive effects of FCV on pulmonary gas exchange could be demonstrated indicating that these effects 20,21 Mean tracheal pressure could be slightly increased during VCV when patients were ventilated with an I:E ratio of 1:1. Further it should be stated that we did not perform central venous catheterization during the study protocol.…”

PEEP and Mechanical Ventilation: We Are Warned, We Cannot Ignore—Reply

“…Direct measurement of arterial P aCO 2 using arterial blood gas analysis is the accepted standard method; however, the inability of this method to provide continuous monitoring and its invasive nature have spurred research for an alternative method. 1 The studies have focused on end-tidal P CO 2 and transcutaneous measurement of P CO 2 (P tcCO 2 ) due to their ability to provide con-tinuous monitoring and their noninvasive nature. P tcCO 2 is especially used to evaluate alveolar ventilation in patients with nocturnal hypoventilation receiving NIV in the home setting.…”