Dynamic hyperinflation and auto-positive end-expiratory pressure lessons learned over 30 years

John J. Marini

Research output: Contribution to journalReview articlepeer-review

99 Scopus citations


Auto-positive end-expiratory pressure (auto-PEEP; AP) and dynamic hyperinflation (DH) may affect hemodynamics, predispose to barotrauma, increase work of breathing, cause dyspnea, disrupt patient-ventilator synchrony, confuse monitoring of hemodynamics and respiratory system mechanics, and interfere with the effectiveness of pressure-regulated ventilation. Although basic knowledge regarding the clinical physiology and management of AP during mechanical ventilation has evolved impressively over the 30 years since DH and AP were first brought to clinical attention, novel and clinically relevant characteristics of this complex phenomenon continue to be described. This discussion reviews some of the more important aspects of AP that bear on the care of the ventilated patient with critical illness.

Original languageEnglish (US)
Pages (from-to)756-762
Number of pages7
JournalAmerican journal of respiratory and critical care medicine
Issue number7
StatePublished - Oct 1 2011


  • Airflow obstruction
  • Auto-positive endexpiratory pressure
  • Dynamic hyperinflation
  • Gas trapping
  • Intrinsic positive end-expiratory pressure
  • Mechanical ventilation
  • Monitoring


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