Title: Vent Management: Finding the AutoPEEP!
题目：通气管理：如何判断内源性PEEP
Author 作者: John Greenwood

There are 3 ways you can look for evidence of Auto-PEEP on the ventilator:
有3种方法可以判断呼吸机使用中的内源性PEEP的存在：

Do an end-expiratory hold:  If the measured PEEP is more than the PEEP set on the vent after a 2-3 second hold, the difference is your Auto-PEEP.
做一个呼气末暂停：如果在暂停2-3秒后测得的呼气末正压超过了呼吸机设定的PEEP，其差值就是你的内源性PEEP。
Look at the expiratory flow waveform:  If the waveform does not return to baseline (still expiring when inspiratory ventilation occurs), there's Auto-PEEP!
检查呼气期流速波形：如果波形不回到基线（呼吸机通气时，病人还处于呼气状态），说明有内源性PEEP！
Compare the inspiratory vs. expiratory volumes.  If the inspiratory volumes are much higher then the expiratory volumes, consider Auto-PEEP.
比较呼气和吸气容量：如果吸气量明显高于呼气量，要考虑内源性PEEP。

References 参考文献：
Blanch L, Bernabé F, Lucangelo U. Measurement of air trapping, intrinsic positive end-expiratory pressure, and dynamic hyperinflation in mechanically ventilated patients. Respir Care. 2005;50(1):110-23.