Tuberc Respir Dis.  2004 Dec;57(6):567-572. 10.4046/trd.2004.57.6.567.

Different PEEP Effects on Lung Volume According to Underlying Lung Disease in Patients with Auto-PEEP

• Sohn JW
• Koh Y

• KMID: 2133005
• DOI: http://doi.org/10.4046/trd.2004.57.6.567

Abstract

BACKGROUND: The effect of PEEP(ed note: Define PEEP.) on the lung volume in patients with auto-PEEP during mechanical ventilation is not even. In patients with an expiratory limitation such as COPD, a PEEP of 85% from an auto-PEEP can be used with minimal increase in the lung volume. However, the application of PEEP to patients without an expiratory flow limitation can result in progressive lung. This study was carried out to evaluate the different PEEP effects on the lung volume according to the different pulmonary diseases.
METHODS
Sixteen patients who presented with auto-PEEP during mechanical ventilation were enrolled in this study. These patients were divided into 3 groups: asthma, COPD and tuberculosis sequela (patients with severe cicatrical fibrosis as a result of previous tuberculosis and compensatory emphysema). A PEEP of 25, 50, 75 and 100% of the auto-PEEP was applied, and the lung volume increments were estimated using the trapped lung volume.
RESULTS
In the asthma group, the trapped lung volume was not increased at a PEEP of 25 and 50% of the auto-PEEP. This group showed a significant lung volume increment from a 75% PEEP. In the COPD group, the lung volume was increased only at 100% PEEP. In the tuberculosis sequela group, the lung volume was increased progressively from low PEEP levels. However, a significant increment of the lung volume was noted only at 100% PEEP.
CONCLUSION
The effects of the applied PEEP on the lung volume were different depending on the underlying lung pathology. The level of the applied PEEP >50% of the auto-PEEP might increase the trapped lung volume in patients with asthma.

Keyword

Auto-PEEP; Applied PEEP; Trapped lung volume; Asthma; COPD

MeSH Terms

Asthma
Fibrosis
Humans
Lung Diseases*
Lung*
Pathology
Positive-Pressure Respiration, Intrinsic*
Pulmonary Disease, Chronic Obstructive
Respiration, Artificial
Tuberculosis