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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
Cleve Clin J Med 2005 Sep;72(9):801-9. doi: 10.3949/ccjm.72.9.801. PMID: 16193827
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
Milic-Emili J
Recenti Prog Med 1990 Nov;81(11):733-7. PMID: 2126881

Recent clinical studies

Etiology

Vitacca M, Ceriana P, Prediletto I, Carlucci A, Paneroni M, Ambrosino N, Nava S
Respiration 2020;99(12):1129-1135. Epub 2020 Dec 3 doi: 10.1159/000511266. PMID: 33271563
Mowery NT
Surg Clin North Am 2017 Dec;97(6):1381-1397. doi: 10.1016/j.suc.2017.07.006. PMID: 29132514
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
Natalini G, Tuzzo D, Rosano A, Testa M, Grazioli M, Pennestrì V, Amodeo G, Marsilia PF, Tinnirello A, Berruto F, Fiorillo M, Filippini M, Peratoner A, Minelli C, Bernardini A; VENTILAB Group
Respir Care 2016 Feb;61(2):134-41. Epub 2015 Nov 24 doi: 10.4187/respcare.04063. PMID: 26604329
Smyth RJ
Can Respir J 1998 Nov-Dec;5(6):485-90. doi: 10.1155/1998/356467. PMID: 10070176

Diagnosis

Carrillo-Esper R, Mejía-Gómez L, Monares-Zepeda E, Chavarría-Martínez U, Díaz-Carrillo A, Ayala-León M, Zamora-Gómez S, Sánchez-Díaz JS, Lomelí-Terán M, Briones-Garduño JC, Pérez-Calatayud ÁA
Cir Cir 2020;88(6):805-817. doi: 10.24875/CIRU.20000301. PMID: 33254199
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
Laghi F, Goyal A
Minerva Anestesiol 2012 Feb;78(2):201-21. Epub 2011 Nov 18 PMID: 21971439
Blanch L, Bernabé F, Lucangelo U
Respir Care 2005 Jan;50(1):110-23; discussion 123-4. PMID: 15636649
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

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
Berlin D
J Intensive Care Med 2014 Mar-Apr;29(2):81-6. Epub 2012 May 15 doi: 10.1177/0885066612445712. PMID: 22588373
Blanch L, Bernabé F, Lucangelo U
Respir Care 2005 Jan;50(1):110-23; discussion 123-4. PMID: 15636649
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
Smyth RJ
Can Respir J 1998 Nov-Dec;5(6):485-90. doi: 10.1155/1998/356467. PMID: 10070176

Prognosis

Liang G, Zhang Z
Clin Respir J 2018 Feb;12(2):674-680. Epub 2016 Nov 10 doi: 10.1111/crj.12578. PMID: 27805309
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
Gemma M, Nicelli E, Corti D, De Vitis A, Patroniti N, Foti G, Calvi MR, Beretta L
J Clin Anesth 2016 Jun;31:124-30. Epub 2016 Apr 16 doi: 10.1016/j.jclinane.2016.01.029. PMID: 27185694
Hough CL, Kallet RH, Ranieri VM, Rubenfeld GD, Luce JM, Hudson LD
Crit Care Med 2005 Mar;33(3):527-32. doi: 10.1097/01.ccm.0000155782.86244.42. PMID: 15753743
Lu Q, Rouby JJ
Crit Care 2000;4(2):91-100. Epub 2000 Mar 21 doi: 10.1186/cc662. PMID: 11094498Free PMC Article

Clinical prediction guides

Vitacca M, Ceriana P, Prediletto I, Carlucci A, Paneroni M, Ambrosino N, Nava S
Respiration 2020;99(12):1129-1135. Epub 2020 Dec 3 doi: 10.1159/000511266. PMID: 33271563
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
Gemma M, Nicelli E, Corti D, De Vitis A, Patroniti N, Foti G, Calvi MR, Beretta L
J Clin Anesth 2016 Jun;31:124-30. Epub 2016 Apr 16 doi: 10.1016/j.jclinane.2016.01.029. PMID: 27185694
Blanch L, Bernabé F, Lucangelo U
Respir Care 2005 Jan;50(1):110-23; discussion 123-4. PMID: 15636649
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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