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Positive-Pressure Respiration, Intrinsic

MedGen UID:
69231
Concept ID:
C0242676
Disease or Syndrome
Synonyms: Auto PEEP; Auto-PEEP; AutoPEEP; Intrinsic PEEP; Intrinsic Positive-Pressure Respiration; Non Therapeutic Positive Pressure Respiration; Non-Therapeutic Positive-Pressure Respiration; Nontherapeutic Positive Pressure Respiration; Nontherapeutic Positive-Pressure Respiration; Occult PEEP; Occult Positive-Pressure Respiration; PEEP, Intrinsic; PEEP, Occult; Positive Pressure Respiration, Intrinsic; Positive Pressure Respiration, Non Therapeutic; Positive Pressure Respiration, Nontherapeutic; Positive Pressure Respiration, Occult; Positive-Pressure Respiration, Non-Therapeutic; Positive-Pressure Respiration, Nontherapeutic; Positive-Pressure Respiration, Occult; Respiration, Intrinsic Positive-Pressure; Respiration, Non Therapeutic Positive Pressure; Respiration, Non-Therapeutic Positive-Pressure; Respiration, Nontherapeutic Positive Pressure; Respiration, Nontherapeutic Positive-Pressure; Respiration, Occult Positive-Pressure

Definition

Non-therapeutic positive end-expiratory pressure occurring frequently in patients with severe airway obstruction. It can appear with or without the administration of external positive end-expiratory pressure (POSITIVE-PRESSURE RESPIRATION). It presents an important load on the inspiratory muscles which are operating at a mechanical disadvantage due to hyperinflation. Auto-PEEP may cause profound hypotension that should be treated by intravascular volume expansion, increasing the time for expiration, and/or changing from assist mode to intermittent mandatory ventilation mode. (From Harrison''s Principles of Internal Medicine, 12th ed, p1127) [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPositive-Pressure Respiration, Intrinsic

Professional guidelines

PubMed

Mughal MM, Culver DA, Minai OA, Arroliga AC
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Recent clinical studies

Etiology

Mowery NT
Surg Clin North Am 2017 Dec;97(6):1381-1397. doi: 10.1016/j.suc.2017.07.006. PMID: 29132514
Zhang C, Pirrone M, Imber DA, Ackman JB, Fumagalli J, Kacmarek RM, Berra L
A A Case Rep 2017 Jan 1;8(1):7-10. doi: 10.1213/XAA.0000000000000408. PMID: 27782908
Zaman J, Van den Bergh O, Fannes S, Van Diest I
Respir Physiol Neurobiol 2014 Sep 15;201:1-6. Epub 2014 Jun 25 doi: 10.1016/j.resp.2014.05.009. PMID: 24973473
Barros AR, Pires MB, Raposo NM
J Bras Pneumol 2013 May-Jun;39(3):317-22. doi: 10.1590/S1806-37132013000300008. PMID: 23857701Free PMC Article
Keith RL, Pierson DJ
Clin Chest Med 1996 Sep;17(3):439-51. doi: 10.1016/s0272-5231(05)70326-9. PMID: 8875006

Diagnosis

Junhasavasdikul D, Telias I, Grieco DL, Chen L, Gutierrez CM, Piraino T, Brochard L
Chest 2018 Oct;154(4):948-962. Epub 2018 Feb 9 doi: 10.1016/j.chest.2018.01.046. PMID: 29432712
Mowery NT
Surg Clin North Am 2017 Dec;97(6):1381-1397. doi: 10.1016/j.suc.2017.07.006. PMID: 29132514
Racca F, Squadrone V, Ranieri VM
Respir Care Clin N Am 2005 Jun;11(2):225-45. doi: 10.1016/j.rcc.2005.01.001. PMID: 15936691
Winters AC
Crit Care Nurs Clin North Am 2004 Sep;16(3):285-91, vii. doi: 10.1016/j.ccell.2004.03.006. PMID: 15358378
Ruggles L
Crit Care Nurse 1995 Apr;15(2):30-8. PMID: 7774245

Therapy

Junhasavasdikul D, Telias I, Grieco DL, Chen L, Gutierrez CM, Piraino T, Brochard L
Chest 2018 Oct;154(4):948-962. Epub 2018 Feb 9 doi: 10.1016/j.chest.2018.01.046. PMID: 29432712
Winters AC
Crit Care Nurs Clin North Am 2004 Sep;16(3):285-91, vii. doi: 10.1016/j.ccell.2004.03.006. PMID: 15358378
Brochard L
Intensive Care Med 2002 Nov;28(11):1552-4. doi: 10.1007/s00134-002-1515-z. PMID: 12583374
Szegedi LL
Anesthesiol Clin North Am 2001 Sep;19(3):435-53, v. doi: 10.1016/s0889-8537(05)70242-x. PMID: 11571901
Jubran A, Tobin MJ
Clin Chest Med 1996 Sep;17(3):453-73. doi: 10.1016/s0272-5231(05)70327-0. PMID: 8875007

Prognosis

Kacmarek RM, Berra L
Lancet Respir Med 2018 Apr;6(4):253-254. Epub 2018 Feb 21 doi: 10.1016/S2213-2600(18)30098-5. PMID: 29477449
Fumagalli J, Berra L, Zhang C, Pirrone M, Santiago RRS, Gomes S, Magni F, Dos Santos GAB, Bennett D, Torsani V, Fisher D, Morais C, Amato MBP, Kacmarek RM
Crit Care Med 2017 Aug;45(8):1374-1381. doi: 10.1097/CCM.0000000000002460. PMID: 28708679
Barros AR, Pires MB, Raposo NM
J Bras Pneumol 2013 May-Jun;39(3):317-22. doi: 10.1590/S1806-37132013000300008. PMID: 23857701Free PMC Article
Zakynthinos SG, Vassilakopoulos T, Zakynthinos E, Mavrommatis A, Roussos C
Am J Respir Crit Care Med 2000 Nov;162(5):1633-40. doi: 10.1164/ajrccm.162.5.9903084. PMID: 11069788
Keith RL, Pierson DJ
Clin Chest Med 1996 Sep;17(3):439-51. doi: 10.1016/s0272-5231(05)70326-9. PMID: 8875006

Clinical prediction guides

Zaman J, Van den Bergh O, Fannes S, Van Diest I
Respir Physiol Neurobiol 2014 Sep 15;201:1-6. Epub 2014 Jun 25 doi: 10.1016/j.resp.2014.05.009. PMID: 24973473
Barros AR, Pires MB, Raposo NM
J Bras Pneumol 2013 May-Jun;39(3):317-22. doi: 10.1590/S1806-37132013000300008. PMID: 23857701Free PMC Article
Blanch L, Bernabé F, Lucangelo U
Respir Care 2005 Jan;50(1):110-23; discussion 123-4. PMID: 15636649
Jubran A
Crit Care Clin 1998 Oct;14(4):629-53, vi. doi: 10.1016/s0749-0704(05)70024-5. PMID: 9891631
Ranieri VM, Dambrosio M, Brienza N
Eur Respir J 1996 Jun;9(6):1283-92. doi: 10.1183/09031936.96.09061283. PMID: 8804950

Recent systematic reviews

Hodgson C, Goligher EC, Young ME, Keating JL, Holland AE, Romero L, Bradley SJ, Tuxen D
Cochrane Database Syst Rev 2016 Nov 17;11(11):CD006667. doi: 10.1002/14651858.CD006667.pub3. PMID: 27855477Free PMC Article
Aldenkortt M, Lysakowski C, Elia N, Brochard L, Tramèr MR
Br J Anaesth 2012 Oct;109(4):493-502. doi: 10.1093/bja/aes338. PMID: 22976857

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