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Dynamic Hyperinflation and Intrinsic Positive End-Expiratory Pressure 

Dynamic Hyperinflation and Intrinsic Positive End-Expiratory Pressure
Chapter:
Dynamic Hyperinflation and Intrinsic Positive End-Expiratory Pressure
Author(s):

John W. Kreit

DOI:
10.1093/med/9780190670085.003.0010
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date: 18 August 2019

Dynamic hyperinflation and intrinsic PEEP almost always occur in patients with severe obstructive lung disease, in whom slowing of expiratory flow prevents complete exhalation. Occasionally, patients without airflow obstruction develop dynamic hyperinflation when expiratory time, is excessively shortened by a rapid respiratory rate, a long set inspiratory time (TI), or both. Dynamic Hyperinflation and Intrinsic Positive End-Expiratory Pressure describes the causes of dynamic hyperinflation and the mechanisms of its adverse effects, including reduced cardiac output and blood pressure, pulmonary barotrauma, and ineffective ventilator triggering. The chapter also describes how to screen for and measure intrinsic PEEP, and how to reduce or eliminate its adverse effects.

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