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.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

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.
Farlex Partner Medical Dictionary © Farlex 2012

positive end-expiratory pressure

McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

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.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012
References in periodicals archive ?
Then the experimental group received manual hyperinflation with positive end expiratory pressure followed by suction while the control group received suction only.
The experimental group then received 20 minutes of manual hyperinflation using a spring loaded valve to keep the positive end expiratory pressure at 10 cm[H.sub.2]O.
The formula used for static compliance was volume oscillation divided by plateau pressure minus positive end expiratory pressure.
A potential cause of respiratory deterioration during manual hyperinflation is disconnection from positive end expiratory pressure and subsequent derecruitment.
Laboratory studies have found that the Mapleson C and/or Mapleson F circuits generated a higher expiratory flow rate (Maxwell and Ellis 2003, Savian et al 2005), particularly at high levels of positive end expiratory pressure (Savian et al 2005) or higher airway pressure or tidal volume (McCarren and Chow 1996), than the Laerdal or Air Viva 2 circuit.
Exclusion criteria included ventilatory requirements of positive end expiratory pressure > 10 cm[H.sub.2]O and Fi[O.sub.2] > 0.6, acute respiratory distress syndrome (Kollef and Schuster 1995), acute pulmonary oedema, acute head injury, mean arterial pressure < 60 mmHg, peak inspiratory airway pressure > 40 cm[H.sub.2]O (as recorded from the ventilator), acute bronchospasm, subcutaneous emphysema or presence of an intercostal catheter with a visible air leak.
Alternatively, the loss of positive end expiratory pressure may have resulted in lung derecruitment (Lapinsky and Mehta 2005, Piacentini et al 2003) Ventilator hyperinflation may be a more effective means of maintaining positive end expiratory pressure (Berney and Denehy 2002).
This means that severely hypoxemic patients are without the benefit of higher positive end expiratory pressures (PEEP) for these periods off NIV, often precipitating severe hypoxemia and the inevitability of invasive mechanical ventilation.
By day 7, Fi[O.sub.2], peak airway and positive end expiratory pressures allowed an uncomplicated percutaneous tracheostomy.

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