Chest
Volume 101, Issue 1, January 1992, Pages 285-286
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Selected Reports
The Effect of Pressure Support Ventilation on Auto-PEEP in a Patient with Asthma

https://doi.org/10.1378/chest.101.1.285Get rights and content

We report the effect of pressure support ventilation (PSV) on auto-PEEP in a patient with asthma. The patient showed a high level of auto-PEEP during spontaneous breathing through a T-piece. PSV effectively decreased auto-PEEP and inspiratory muscle effort with increasing levels of PSV.

Section snippets

CASE REPORT

A 77-year-old woman with a history of asthma was admitted to our hospital for a lung tumor detected on chest roentgenogram. She had no history of chronic bronchitis or emphysema. Admission diagnosis was lung abscess. Preoperatively, the airways appeared to be normal by bronchoscopy. Partial resection of the right upper lobe of the lung was performed. After surgery she was not extubated because wheezing was noted. There was no postoperative hemorrhage in the airway. She was transferred to the

DISCUSSION

The level of auto-PEEP during mechanical ventilation depends on the resistance and compliance of the total respiratory system, TE, and V˙E (calculated from VT and f). Auto-PEEP decreases as V˙E decreases or TE increases. In our patient, an increase in TE during PSV contributed to a decrease in auto-PEEP, despite an increase in VT. However, a PSV level of 15 cm H2O did not decrease auto-PEEP any more than a PSV level of 10 cm H2O did. This plateau of auto-PEEP might be due to the

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