Abstract
Mechanical ventilation with positive end-expiratory pressure (PEEP) is a widely used technique to improve pulmonary oxygenation in patients with the adult respiratory distress syndrome (ARDS) [1]. In contrast, the use of PEEP has generally been discouraged in patients with chronic obstructive pulmonary disease (COPD). This is because the degree of hypoxemia is generally mild (and readily improved with supplemental oxygen alone) and also to avoid the risk of barotrauma due to pulmonary hyperinflation. However, recent studies suggest that application of PEEP may be of benefit in COPD patients when used to improve respiratory muscle efficiency during assisted modes of mechanical ventilation or when weaning is being attempted [2].
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References
Ashbaugh DG, Petty TL (1973) Positive end-expiratory pressure. J Thor Cardiovasc Surgery 65:165–170
Milic-Emili J, Gottfried SB, Rossi A (1987) Dynamic hyperinflation: Intrinsic PEEP and its ramifications in patients with respiratory failure. In: Vincent JL (ed) Update in intensive care and emergency medicine, vol 3. Springer, Berlin Heidelberg New York Tokyo, pp 192–198
Pepe PE, Marini JJ (1982) Occult positive end-expiratory pressure in mechanically ventilated patients with airflow obstruction. Am Rev Respir Dis 126:166–170
Rossi A, Gottfried SB, Zocchi L, et al (1985) Measurement of static compliance of total respiratory system in patients with acute respiratory failure during mechanical ventilation. Am Rev Respir Dis 131:672–678
Smith TC, Marini JJ (1988) Impact of PEEP on lung mechanics and work of breathing in severe airflow obstruction. J Appl Physiol 65:1488–1499
Calderini E, Petrof BJ, Gottfried SB (1989) Continuous positive airway pressure (CPAP) improves the efficacy of pressure support (PS) ventilation in severe chronic obstructive pulmonary disease (COPD). Am Rev Respir Dis 139:A155
Petrof BJ, Legare M, Goldberg P, et al (1990) Continuous airway pressure reduces work of breathing and dyspnea during weaning from mechanical ventilation in severe chronic obstructive pulmonary disease. Am Rev Respir Dis (in press)
Gay PC, Rodarte JR, Hubmayr RD (1989) The effects of positive expiratory pressure on isovolume flow and dynamic hyperinflation in patients receiving mechanical ventilation. Am Rev Respir Dis 139:621–626
Gottfried SB, Rossi A, Higgs BD, et al (1985) Noninvasive determination of respiratory system mechanics during mechanical ventilation for acute respiratory failure. Am Rev Respir Dis 131:414–420
Kimball WR, Leith DE, Robins AG (1982) Dynamic hyperinflation and ventilator dependence in chronic obstructive pulmonary disease. Am Rev Respir Dis 126:991–995
Simkovitz P, Brown K, Goldberg P, et al (1987) Interaction between intrinsic and externally applied PEEP during mechanical ventilation. Am Rev Respir Dis 135:A202
Broseghini C, Brandolese R, Poggi R, et al (1988) Respiratory mechanics during the first day of mechanical ventilation in patients with pulmonary edema and chronic airway obstruction. Am Rev Respir Dis 138:355–361
Broseghini C, Brandolese R, Poggi R, et al (1988) Respiratory resistance and intrinsic positive end-expiratory pressure (PEEPi) in patients with the adult respiratory distress syndrome (ARDS). Eur Respir J 1:726–731
Marini JJ (1989) Should PEEP be used in airflow obstruction? Am Rev Respir Dis 140:1–3
Tuxen DV (1989) Detrimental effects of positive end-expiratory pressure during controlled mechanical ventilation of patients with severe airflow obstruction. Am Rev Respir Dis 140:5–9
Hoffman RA, Ershowsky P, Krieger BF (1989) Determination of auto-PEEP during spontaneous and controlled ventilation by monitoring changes in end-expiratory thoracic gas volume. Chest 3:613–616
Mcllroy MB, Tierney DF, Nadel JA (1963) A new method for measurement of respiratory compliance and resistance of lungs and thorax. J Appl Physiol 17:424–427
Zin WA, Pengelly LD, Milic-Emili J (1982) Single-breath method for measurement of respiratory mechanics in anesthetized animals. J Appl Physiol 52:1266–1277
Berhakis PK, Higgs BD, Baydur A, et al (1983) Respiratory mechanics during halothane anesthesia and anesthesia paralysis in humans. J Appl Physiol 55:1085–1092
Mortola JP, Milic-Emili J, Nowaraj A, et al (1984) Muscle pressure and flow during expiration in infants. Am Rev Respir Dis 129:49–53
Saetta M, Rossi A, Gottfried SB, et al (1985) Expiratory volume-flow relationship during mechanical ventilation in patients with acute respiratory failure. Am Rev Respir Dis 131:A132
Dal Vecchio L, Polese G, Poggi R, Rossi A (1989) Intrinsic PEEP in stable COPD patients. Eur Respir J 2
Bernasconi M, Brandolese R, Rossi A (1988) Advances in the assessment of respiratory function during mechanical ventilation of patients with acute respiratory failure. Int Care World 5:52–54
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Rossi, A., Brandolese, R., Milic-Emili, J. (1990). PEEP in Mechanically Ventilated COPD Patients. In: Vincent, J.L. (eds) Update 1990. Update in Intensive Care and Emergency Medicine, vol 10. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84125-5_27
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DOI: https://doi.org/10.1007/978-3-642-84125-5_27
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-52269-0
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