TAILIEUCHUNG - Giáo trình Auto-PEEP

Auto-positive end-expiratory pressure (auto-PEEP) is a common problem in patients receiving full or partial ventilatory support, as well as in those ready to be weaned from the ventilator. Physicians should be alert for it and take measures to reduce it, as it can have serious consequences. | REVIEW MAJID M. MUGHAL MD Assistant Professor of Medicine University of South Alabama Medical Center Mobile OMAR A. MINAI MD Department of Pulmonary Allergy and Critical Care Medicine The Cleveland Clinic Foundation DANIEL A. CULVER DO Department of Pulmonary Allergy and Critical Care Medicine The Cleveland Clinic Foundation ALEJANDRO C. ARROLIGA MD Professor of Medicine Cleveland Clinic Lerner College of Medicine of Case Western University Head Section of Critical Care Medicine Department of Pulmonary Allergy and Critical Care Medicine The Cleveland Clinic Foundation Auto-positive end-expiratory pressure Mechanisms and treatment ABSTRACT Auto-positive end-expiratory pressure auto-PEEP is a common problem in patients receiving full or partial ventilatory support as well as in those ready to be weaned from the ventilator. Physicians should be alert for it and take measures to reduce it as it can have serious consequences. KEY POINTS Auto-PEEP occurs much more frequently than was previously thought. Auto-PEEP and dynamic hyperinflation may cause significant discomfort and precipitate patient-ventilator asynchrony through several mechanisms. Auto-PEEP increases the work of breathing and can worsen gas exchange and decrease cardiac output. In some patients with auto-PEEP due to airflow obstruction and dynamic hyperinflation external PEEP may be used to decrease the work of breathing and relieve dyspnea. 0UTO-POSITIVE END-EXPIRATORY PRESSURE auto-PEEP a common problem in patients receiving mechanical ventilation can have serious consequences. The clinician needs to fully understand the physiology of auto-PEEP so as to choose appropriate ventilator settings. Why should generalists think about mechanical ventilation A recent study showed that intensivists care for only of critically ill patients in the United States while general internists surgeons and anesthesiologists manage the The incidence of acute respiratory failure requiring mechanical ventilation .

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