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intrinsic positive end-expiratory pressure

   Also found in: Acronyms 0.03 sec.
intrinsic positive end-expiratory pressure (intrinsic PEEP),
elevated positive end-expiratory pressure and dynamic pulmonary hyperinflation caused by insufficient expiratory time or a limitation on expiratory flow. It cannot be routinely measured by a ventilator's pressure monitoring system but only by an expiratory hold maneuver done by the clinician. Its presence increases the work required to trigger the ventilator, causes errors in the calculation of pulmonary compliance, may cause hemodynamic compromise, and complicates interpretation of hemodynamic measurements. Also called auto-PEEP.


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In addition, any increase in EELV above relaxation volume results in an intrinsic positive end-expiratory pressure (PEEPi), which must be overcome before inspiratory flow can start (11).
Studies of patients in intensive care units have shown that the resistive and elastic work of breathing increases significantly during exacerbations, which leads to a marked increase in intrinsic positive end-expiratory pressure (11, 12).
In these patients, delayed cycling can worsen dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEP^sub i^), increase the number of nontriggering breaths and promote patient-ventilator asynchrony, increase the work of breathing (2, 5), and interfere with breathing pattern (6).
 
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