@article {Blanch110, author = {Llu{\'\i}s Blanch and Francesca Bernab{\'e} and Umberto Lucangelo}, title = {Measurement of Air Trapping, Intrinsic Positive End-Expiratory Pressure, and Dynamic Hyperinflation in Mechanically Ventilated Patients}, volume = {50}, number = {1}, pages = {110--124}, year = {2005}, publisher = {Respiratory Care}, abstract = {Severe airflow obstruction is a common cause of acute respiratory failure. Dynamic hyperinflation affects tidal ventilation, increases airways resistance, and causes intrinsic positive end-expiratory pressure (auto-PEEP). Most patients with asthma and chronic obstructive pulmonary disease have dynamic hyperinflation and auto-PEEP during mechanical ventilation, which can cause hemodynamic compromise and barotrauma. Auto-PEEP can be identified in passively breathing patients by observation of real-time ventilator flow and pressure graphics. In spontaneously breathing patients, auto-PEEP is measured by simultaneous recordings of esophageal and flow waveforms. The ventilatory pattern should be directed toward minimizing dynamic hyperinflation and auto-PEEP by using small tidal volume and preserving expiratory time. With a spontaneously breathing patient, to reduce the work of breathing and improve patient-ventilator interaction, it is crucial to set an adequate inspiratory flow, inspiratory time, trigger sensitivity, and ventilator-applied PEEP. Ventilator graphics are invaluable for monitoring and treatment decisions at the bedside.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/50/1/110}, eprint = {https://rc.rcjournal.com/content/50/1/110.full.pdf}, journal = {Respiratory Care} }