mechanical ventilation q

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What's the difference between auto-peep and breath stacking? Is breath stacking just a larger volume? I haven't been able to get any straightforward answers about this. I asked the respiratory therapist at the hospital also, and he was at a loss for how to explain it. So far the answers I'm getting are along the lines of "it's kind of the same thing, but not exactly."

Specializes in Critical Care.

It's basically the same thing, breath stacking is a physical action that contributes to auto-peep. The two terms are often used interchangeably.

Breath stacking occurs when exhalation time is too short or the I:E ratio is inappropriate. This leads to Auto PEEP.

You can see this graphically by the wave forms and by the baseline for air trapping. The digital display gives the I:E ratio. Auto PEEP is a measured value which the RTS should be doing during their assessment.

The causes can be inadequate ventilator settings for flow, sensitivity or I-time. Sedation can also be a factor especially if running a low volume protective protocol. Other causes can include inappropriate vent settings for uncorrected metabolic issues or incorrect flow and PEEP settings for the pulmonary condition. Some under PEEP or fear the flow.

These issues are also why RTS get upset if someone else makes ventilator changes. A higher rate may need higher flow or I-time adjustments and an Auto PEEP check. And then there's the adjustment of alarms to reflect the changes.

Breath stacking occurs when exhalation time is too short or the I:E ratio is inappropriate. This leads to Auto PEEP.

You can see this graphically by the wave forms and by the baseline for air trapping. The digital display gives the I:E ratio. Auto PEEP is a measured value which the RTS should be doing during their assessment.

The causes can be inadequate ventilator settings for flow, sensitivity or I-time. Sedation can also be a factor especially if running a low volume protective protocol. Other causes can include inappropriate vent settings for uncorrected metabolic issues or incorrect flow and PEEP settings for the pulmonary condition. Some under PEEP or fear the flow.

These issues are also why RTS get upset if someone else makes ventilator changes. A higher rate may need higher flow or I-time adjustments and an Auto PEEP check. And then there's the adjustment of alarms to reflect the changes.

Thanks so much! I understand it now.

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