Adding Extrinsic PEEP in Dynamic Hyperinflation Syndrome

Adding extrinsic positive end-expiratory pressure (PEEP) in dynamic hyperinflation syndrome can help decrease the work of breathing in patients with auto-PEEP on mechanical ventilation with spontaneous efforts. This educational video explains this concept in details.

[@920105abcdel]

very clear, thanks

[@aniqabano1582]

Thanks. Very helpful

[@criticalmass500]

Nice

[@osamahegazy6114]

Adding extrinsic peep will not cause hemodynamic instability ?

[@ICUREACH]

It may

[@Metalignant]

I've been thinking about this all day, finally my question is answered!
Follow up question: How does bipap help to fix hyperinflation. I see from your video how the respiratory effort is decreased with extrinsic PEEP, but what is the mechanism that increases tidal volume? How does PEEP help the patient with poor recoil expire more gas from hyperinflated lungs?

[@ICUREACH]

In order to improve hyperinflation, you need to allow for a prolonged expiratory time which may not be possible with non-invasive ventilation as it respiratory rate is determined by the patient. You can decrease inspiratory time settings but expiratory time cannot be controlled. This is different when the patient is intubated where you can sedate and paralyze then determine I:E ratio