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The Role of PEEP in the Mechanically Ventilated COPD Patient

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Ventilatory Failure

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 15))

Abstract

The approach to mechanical ventilation (MV) of the critically ill patient will vary according to the pathophysiological events underlying the development of acute respiratory failure. In this regard, it is clinically useful to classify acute respiratory failure into two major categories — “type 1” or hypoxemic respiratory failure and “type 2” or hypercapnic ventilatory failure [1]. The former category is best examplified by the adult respiratory distress syndrome (ARDS). The underlying pathophysiology in this condition is one of diffuse alveolar injury characterized by extensive alveolar edema and collapse, a reduction in lung volume, and marked hypoxemia relatively refractory to high inspired concentrations of oxygen [2]. MV with the addition of positive end-expiratory pressure (PEEP) is the treatment modality most commonly employed to improve oxygenation in such patients. PEEP is considered to act through its ability to re-expand flooded and atelectatic alveolar units, increase functional residual capacity, and thereby reduce the magnitude of venous admixture [2].

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  1. S. B. Gottfried
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Editors and Affiliations

  1. St. Paul-Ramsey Medical Center, 640 Jackson Street, St. Paul, MN, 55101-2595, USA

    J. J. Marini

  2. Department of Critical Care, Evangelismos Hospital, 45, Ipsilandou Street, Athens, 11521, Greece

    C. Roussos

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Gottfried, S.B. (1991). The Role of PEEP in the Mechanically Ventilated COPD Patient. In: Marini, J.J., Roussos, C. (eds) Ventilatory Failure. Update in Intensive Care and Emergency Medicine, vol 15. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84554-3_23

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  • DOI: https://doi.org/10.1007/978-3-642-84554-3_23

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-84556-7

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