Auto PEEP (auto positive end expiratory pressure) may occur during mechanical ventilation. It can result in a number of complications. It is also called occult PEEP since it may be difficult to detect.


Synonym: intrinsic PEEP


Features of auto-PEEP:

(1) incomplete emptying of the lung during expiration

(2) air trapping


Continued cycles of air trapping can result in alveolar hyperinflation.


Risk factors:

(1) high airway resistance, especially during expiration

(2) ventilation with a limited expiratory time

(3) increased airway secretions

(4) increased lung compliance

(5) obstructive lung disease


Potential complications:

(1) increased work of breathing

(2) barotrauma and/or volutrauma

(3) impeded venous return

(4) decreased cardiac output

(5) increased pulmonary vascular resistance


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