Positive end-expiratory pressure (PEEP) is used therapeutically during mechanical ventilation (extrinsic PEEP). It can also be a complication of incomplete expiration and airtrapping (intrinsic PEEP).
Clinical aspects of extrinsic and intrinsic and PEEP are discussed in this topic review. High levels of PEEP that have been investigated in patients with acute respiratory distress syndrome as well as the application of PEEP in patients with dynamic hyperinflation from asthma and chronic obstructive pulmonary disease are described separately. (See "Mechanical ventilation of adults in acute respiratory distress syndrome", section on 'High PEEP' and "Invasive mechanical ventilation in acute respiratory failure complicating chronic obstructive pulmonary disease", section on 'Dynamic hyperinflation' and "Invasive mechanical ventilation in adults with acute exacerbations of asthma", section on 'Intrinsic PEEP'.)
Positive end-expiratory pressure (PEEP) is the alveolar pressure above atmospheric pressure that exists at the end of expiration. There are two types of PEEP:
●Extrinsic PEEP – PEEP that is provided by a mechanical ventilator is referred to as applied PEEP
●Intrinsic PEEP – PEEP that is secondary to incomplete expiration is referred to as intrinsic PEEP or auto-PEEP