positive end-expiratory pressure

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 (P) [presh´ur]
force per unit area.
arterial pressure (arterial blood pressure) blood pressure (def. 2).
atmospheric pressure the pressure exerted by the atmosphere, usually considered as the downward pressure of air onto a unit of area of the earth's surface; the unit of pressure at sea level is one atmosphere. Pressure decreases with increasing altitude.
barometric pressure atmospheric p.
blood pressure
2. pressure of blood on walls of any blood vessel.
capillary pressure the blood pressure in the capillaries.
central venous pressure see central venous pressure.
cerebral perfusion pressure the mean arterial pressure minus the intracranial pressure; a measure of the adequacy of cerebral blood flow.
cerebrospinal pressure the pressure of the cerebrospinal fluid, normally 100 to 150 mm Hg.
continuous positive airway pressure see continuous positive airway pressure.
filling pressure see mean circulatory filling pressure.
high blood pressure hypertension.
intracranial pressure see intracranial pressure.
intraocular pressure the pressure exerted against the outer coats by the contents of the eyeball.
intrapleural pressure (intrathoracic pressure) pleural pressure.
intrinsic positive end-expiratory pressure 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 is measurable only using an expiratory hold maneuver done by the clinician. Its presence increases the work needed to trigger the ventilator, causes errors in the calculation of pulmonary compliance, may cause hemodynamic compromise, and complicates interpretation of hemodynamic measurements. Called also auto-PEEP and intrinsic PEEP.
maximal expiratory pressure maximum expiratory pressure.
maximal inspiratory pressure the pressure during inhalation against a completely occluded airway; used to evaluate inspiratory respiratory muscle strength and readiness for weaning from mechanical ventilation. A maximum inspiratory pressure above −25 cm H2O is associated with successful weaning.
maximum expiratory pressure (MEP) a measure of the strength of respiratory muscles, obtained by having the patient exhale as strongly as possible against a mouthpiece; the maximum value is near total lung capacity.
maximum inspiratory pressure (MIP) the inspiratory pressure generated against a completely occluded airway; used to evaluate inspiratory respiratory muscle strength and readiness for weaning from mechanical ventilation. A maximum inspiratory pressure above −25 cm H2O is associated with successful weaning.
mean airway pressure the average pressure generated during the respiratory cycle.
mean circulatory filling pressure a measure of the average (arterial and venous) pressure necessary to cause filling of the circulation with blood; it varies with blood volume and is directly proportional to the rate of venous return and thus to cardiac output.
negative pressure pressure less than that of the atmosphere.
oncotic pressure the osmotic pressure of a colloid in solution.
osmotic pressure the pressure required to stop osmosis through a semipermeable membrane between a solution and pure solvent; it is proportional to the osmolality of the solution. Symbol π.
partial pressure the pressure exerted by each of the constituents of a mixture of gases.
peak pressure in mechanical ventilation, the highest pressure that occurs during inhalation.
plateau pressure in mechanical ventilation, the pressure measured at the proximal airway during an end-inspiratory pause; a reflection of alveolar pressure.
pleural pressure the pressure between the visceral pleura and the thoracic pleura in the pleural cavity. Called also intrapleural or intrathoracic pressure.
positive pressure pressure greater than that of the atmosphere.
positive end-expiratory pressure (PEEP) a method of control mode ventilation in which positive pressure is maintained during expiration to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange. A PEEP higher than the critical closing pressure prevents alveolar collapse and can markedly improve the arterial Po2 in patients with a lowered functional residual capacity, as in acute respiratory failure.
Effects of the application of positive end-expiratory pressure (PEEP) on the alveoli. A, Atelectatic alveoli before PEEP application. B, Optimal PEEP application has reinflated alveoli to normal volume. C, Excessive PEEP application overdistends the alveoli and compresses adjacent pulmonary capillaries, creating dead space with its attendant hypercapnia. From Pierce, 1995.
pulmonary artery wedge pressure (PAWP) (pulmonary capillary wedge pressure (PCWP)) intravascular pressure, reflecting the left ventricular end diastolic pressure, measured by a swan-ganz catheter wedged into a small pulmonary artery to block the flow from behind.
pulse pressure the difference between the systolic and diastolic pressures. If the systolic pressure is 120 mm Hg and the diastolic pressure is 80 mm Hg, the pulse pressure is 40 mm Hg; the normal pulse pressure is between 30 and 40 mm Hg.
urethral pressure the pressure inwards exerted by the walls of the urethra, which must be counteracted in order for urine to flow through; see also urethral pressure profile.
venous pressure the blood pressure in the veins; see also central venous pressure.
water vapor pressure the tension exerted by water vapor molecules, 47 mm Hg at normal body temperature.
wedge pressure blood pressure measured by a small catheter wedged into a vessel, occluding it; see also pulmonary capillary wedge pressure and wedged hepatic vein pressure.
wedged hepatic vein pressure the venous pressure measured with a catheter wedged into the hepatic vein. The difference between wedged and free hepatic vein pressures is used to locate the site of obstruction in portal hypertension; it is elevated in that due to cirrhosis, but low in cardiac ascites or portal vein thrombosis.

pos·i·tive end-ex·pi·ra·to·ry pres·sure (PEEP),

a technique used in respiratory therapy in which airway pressure greater than atmospheric pressure is achieved at the end of exhalation by introduction of a mechanical impedance to exhalation. So-called "auto-PEEP" occurs when increased time is needed for expiration during mechanical ventilation and the next breath is delivered before the system pressure has dropped to 0; this can be a dangerous phenomenon, which may lead to barotrauma and hypotension.

positive end-expiratory pressure (PEEP)

positive airway pressure applied at the end of the exhalation phase during mechanical ventilation. Each successive breath begins from a new baseline. Air is delivered in cycles of constant pressure through the respiratory cycle. The patient is usually but not always intubated, and a ventilator cycles the air through an endotracheal tube. PEEP is used for the relief of respiratory distress secondary to prematurity, pancreatitis, shock, pulmonary edema, trauma, surgery, or other conditions in which spontaneous respiratory efforts are inadequate and arterial levels of oxygen are deficient. Close observation is necessary during PEEP therapy because excessive PEEP may decrease venous return to the heart. Blood gases and vital signs are monitored closely. If PEEP does not significantly improve the patient's condition, its level is increased or it may be discontinued. Compare continuous positive airway pressure.

positive end-expiratory pressure


pos·i·tive end-ex·pi·ra·to·ry pres·sure

(PEEP) (poz'i-tiv end-eks-pīr'ă-tōr-ē presh'ŭr)
A technique used in respiratory therapy in which airway pressure greater than atmospheric pressure is achieved at the end of exhalation by introduction of a mechanical impedance to exhalation.
References in periodicals archive ?
ARDSnet ventilatory protocol and alveolar hyperinflation: role of positive end-expiratory pressure.
2] = fractional inspired concentration of oxygen; PEEP = positive end-expiratory pressure in centimeters of water pressure; Vt = tidal volume (in milliliters); b/min = breaths per minute.
Effects of varying levels of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure.
Effects of high versus low positive end-expiratory pressures in acute respiratory distress syndrome.
Effect of mechanical ventilation and positive end-expiratory pressure (PEEP) on chest radiograph.
2] and titration of positive end-expiratory pressure (PEEP) to optimise compliance and oxygenation (10).
25 despite several hours of attempting to improve oxygenation by conventional volume ventilation, optimized positive end-expiratory pressure (PEEP), recruitment maneuvers, pressure-controlled ventilation, prone positioning, and high-frequency oscillatory ventilation.
Olivier Desebbe at Louis Pradel Hospital in Lyon-Bron, France, studied the ability of PVI to predict the effects of positive end-expiratory pressure (PEEP) on cardiac index (CI) in 21 mechanically-ventilated patients following cardiac surgery.
Anderson J, Qvist J, Kann T (1979) Recruiting collapsed lung through collateral channels with positive end-expiratory pressure.
Mechanical ventilation with positive end-expiratory pressure in critically ill patients: comparison of CW-Doppler ultrasound cardiac output monitoring (USCOM) and thermodilution (PiCCO).
Ventilation was provided by bellows, expiration occurring through a series of flap valves and water jars to maintain positive end-expiratory pressure (4,5).
infiltrated quadrants on chest radiograph Positive end-expiratory pressure requirement Pulmonary compliance Uncompensated hypercapnea (pH<7.

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