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In retrospect, the "discovery" of auto-PEEP and the devising of a practical means for its detection took place over a span of less than 30 minutes.
Offsetting auto-PEEP initially presented a problem for PAV, but steps have been taken recently to effectively address it.
Were I to advise RCPs in practice or in training, it would be to prepare well in physiology, to question what you do not understand from a base of confidence gained from that physiological knowledge, and to look very carefully--there are more phenomena like auto-PEEP waiting to be described by the brightest and most committed among you.
They include: lung compliance and airway resistance, the set pressure level, the amount of auto-PEEP and the patient's effort.
The resulting tidal volume is dependent on airway resistance, chest wall and lung compliance and the amount of auto-PEEP.
This assists in oxygenation and may be increased to assist patient triggering of the ventilator by overcoming their auto-PEEP.