WordNet

put an end to; "The terrible news ended our hopes that he had survived"
a final state; "he came to a bad end"; "the so-called glorious experiment came to an inglorious end" (同)destruction, death
the point in time at which something ends; "the end of the year"; "the ending of warranty period" (同)ending
bring to an end or halt; "She ended their friendship when she found out that he had once been convicted of a crime"; "The attack on Poland terminated the relatively peaceful period after WW I" (同)terminate
a piece of cloth that is left over after the rest has been used or sold (同)remainder, remnant, oddment
(American football) a position on the line of scrimmage; "no one wanted to play end"
the part you are expected to play; "he held up his end"
the concluding parts of an event or occurrence; "the end was exciting"; "I had to miss the last of the movie" (同)last, final_stage
either extremity of something that has length; "the end of the pier"; "she knotted the end of the thread"; "they rode to the end of the line"; "the terminals of the anterior arches of the fornix" (同)terminal
(football) the person who plays at one end of the line of scrimmage; "the end managed to hold onto the pass"
a boundary marking the extremities of something; "the end of town"
a final part or section; "we have given it at the end of the section since it involves the calculus"; "Start at the beginning and go on until you come to the end"
one of two places from which people are communicating to each other; "the phone rang at the other end"; "both ends wrote at the same time"
the surface at either extremity of a three-dimensional object; "one end of the box was marked `This side up"
have an end, in a temporal, spatial, or quantitative sense; either spatial or metaphorical; "the bronchioles terminate in a capillary bed"; "Your rights stop where you infringe upon the rights of other"; "My property ends by the bushes"; "The symphony ends in a pianissimo" (同)stop, finish, terminate, cease
be the end of; be the last or concluding part of; "This sad scene ended the movie" (同)terminate
reckoned, situated or tending in the direction which naturally or arbitrarily is taken to indicate increase or progress or onward motion; "positive increase in graduating students"
a film showing a photographic image whose tones correspond to those of the original subject
the primary form of an adjective or adverb; denotes a quality without qualification, comparison, or relation to increase or diminution (同)positive degree
indicating existence or presence of a suspected condition or pathogen; "a positive pregnancy test" (同)confirming
having a positive charge; "protons are positive" (同)electropositive, positively charged
formally laid down or imposed; "positive laws" (同)prescribed
characterized by or displaying affirmation or acceptance or certainty etc.; "a positive attitude"; "the reviews were all positive"; "a positive benefit"; "a positive demand"
greater than zero; "positive numbers"
the force applied to a unit area of surface; measured in pascals (SI unit) or in dynes (cgs unit); "the compressed gas exerts an increased pressure" (同)pressure level, force per unit area
an oppressive condition of physical or mental or social or economic distress
the somatic sensation that results from applying force to an area of skin; "the sensitivity of his skin to pressure and temperature was normal" (同)pressure_sensation
a force that compels; "the public brought pressure to bear on the government"
event whose occurrence ends something; "his death marked the ending of an era"; "when these final episodes are broadcast it will be the finish of the show" (同)conclusion, finish
the end of a word (a suffix or inflectional ending or final morpheme); "I dont like words that have -ism as an ending" (同)termination
of or relating to the breathing out phase of respiration

PrepTutorEJDIC

(細いものの)『端』,先端《+『of』+『名』》 / (物語などの)『終り』,終結部《+『of』+『名』》 / (物事・期間の)『最後』《+『of』+『名』》;(…に)結末をつけるもの《+『to』+『名』》 / (…の)端の部分,末端部《『of』+『名』》 / 《しばしば複数形で》『目的』(purpose),目標(aim) / 《遠回しに》死,滅亡 / 《しばしば複数形で》切れ端,くず,残りもの / (事業などの)部門(part) / (フットボールで)エンド)前衛両端の選手または位置) / …‘を'『終わらせる』,終える / 〈物事が〉…‘の'終りとなる,‘を'締めくくる / 『終わる』,終了する(come to an end)
『肯定した,同意の』 / 『実際的な,』積極的な,建設的な / 《補語にのみ用いて》『確信のある』,自信のある / (事が)疑問の余地がない,明確な;(言葉が)はっきりした / 《名詞の前にのみ用いて》《話》全くの,文字どおりの / (生体の反応が)陽性の / (数が)正の,プラスの;(気電が)陽の;(写真で)陽画の / (形容詞・副詞の比較変化で)原級の / 明確(明白)なもの / (形容詞・副詞の)原級 / (写真の)陽画,ポジ / (数学で)正数
〈U〉『押すこと』,『押しつけること』,圧搾,圧縮;〈C〉〈U〉『圧力』,圧力の強さ / 〈U〉『圧迫』,『強制』 / 〈U〉(不快な)圧迫感 / 〈C〉〈U〉(精神的な)重荷,苦脳;(時間・金銭的)切迫 / 〈U〉多忙,あわただしさ / 《おもに米》…‘に'圧力をかける,強制する(《英》pressurise)
終り,終了;(物語・映画などの)結末 / (文の)語尾
(肺から)息を吐く,呼気の

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/07/29 17:20:56」(JST)

wiki en

Positive end-expiratory pressure (PEEP) is the pressure in the lungs (alveolar pressure) above atmospheric pressure (the pressure outside of the body) that exists at the end of expiration.^[1] The two types of PEEP are extrinsic PEEP (PEEP applied by a ventilator) and intrinsic PEEP (PEEP caused by an incomplete exhalation). Pressure that is applied or increased during an inspiration is termed pressure support.

Intrinsic PEEP (auto)

Auto (intrinsic) PEEP — Incomplete expiration prior to the initiation of the next breath causes progressive air trapping (hyperinflation). This accumulation of air increases alveolar pressure at the end of expiration, which is referred to as auto-PEEP.

Auto-PEEP develops commonly in high minute ventilation (hyperventilation), expiratory flow limitation (obstructed airway) and expiratory resistance (narrow airway).

Once auto-PEEP is identified, steps should be taken to stop or reduce the pressure build-up.^[2] When auto-PEEP persists despite management of its underlying cause, applied PEEP may be helpful if the patient has an expiratory flow limitation (obstruction).^[3]^[4]

Extrinsic PEEP (applied)

Applied (extrinsic) PEEP — is usually one of the first ventilator settings chosen when mechanical ventilation is initiated. It is set directly on the ventilator.

A small amount of applied PEEP (4 to 5 cmH₂O) is used in most mechanically ventilated patients to mitigate end-expiratory alveolar collapse.^[5] A higher level of applied PEEP (>5 cmH₂O) is sometimes used to improve hypoxemia or reduce ventilator-associated lung injury in patients with acute lung injury, acute respiratory distress syndrome, or other types of hypoxemic respiratory failure.^[6]

Complications

Positive end-expiratory pressure can contribute to:

Decrease in systemic venous return
Pulmonary barotrauma can be caused. Pulmonary barotrauma is lung injury that results from the hyperinflation of alveoli past the rupture point.
The effects of PEEP on intracranial pressure (ICP) have been studied. Although PEEP is hypothesized to increase ICP due to impedance of cerebral blood flow, it has been shown that high PEEP does not increase ICP.^[7]^[8]
Renal functions and electrolyte imbalances, due to decreased venous return metabolism of certain drugs are altered and acid-base balance is impeded.^[9]

History

John Scott Inkster an English anaesthetist and physician is credited with discovering PEEP.^[10]

References

^ "Positive end-expiratory pressure (PEEP)". TheFreeDictionary.com. Citing: Saunders Comprehensive Veterinary Dictionary. 2007.
^ Caramez, MP; Borges, JB; Tucci, MR; Okamoto, VN; et al. (2005). "Paradoxical responses to positive end-expiratory pressure in patients with airway obstruction during controlled ventilation". Crit Care Med 33 (7): 1519–28. doi:10.1097/01.CCM.0000168044.98844.30. PMC 2287196. PMID 16003057.
^ Smith, TC; Marini, JJ (1988). "Impact of PEEP on lung mechanics and work of breathing in severe airflow obstruction". J Appl Physiol 65 (4): 1488–99. PMID 3053583.
^ Kondili, E; Alexopoulou, C; Prinianakis, G; Xirouchaki, N; et al. (2004). "Pattern of lung emptying and expiratory resistance in mechanically ventilated patients with chronic obstructive pulmonary disease". Intensive Care Med 30 (7): 1311–8. doi:10.1007/s00134-004-2255-z. PMID 15054570.
^ Manzano, F; Fernández-Mondéjar, E; Colmenero, M; Poyatos, ME; et al. (2008). "Positive-end expiratory pressure reduces incidence of ventilator-associated pneumonia in nonhypoxemic patients". Crit Care Med 36 (8): 2225–31. doi:10.1097/CCM.0b013e31817b8a92. PMID 18664777.
^ Smith, RA (1988). "Physiologic PEEP". Respir Care 33: 620.
^ Frost, EA (1977). "Effects of positive end-expiratory pressure on intracranial pressure and compliance in brain-injured patients". J Neurosurg 47 (2): 195–200. doi:10.3171/jns.1977.47.2.0195. PMID 327031.
^ Caricato, A; Conti, G; Della Corte, F; Mancino, A; et al. (March 2005). "Effects of PEEP on the intracranial system of patients with head injury and subarachnoid hemorrhage: The role of respiratory system compliance". The Journal of Trauma and Acute Care Surgery 58 (3): 571–6. doi:10.1097/01.ta.0000152806.19198.db. PMID 15761353.
^ Oliven, A; Taitelman, U; Zveibil, F; Bursztein, S (March 1980). "Effect of positive end-expiratory pressure on intrapulmonary shunt at different levels of fractional inspired oxygen". Thorax 35 (3): 181–5. doi:10.1136/thx.35.3.181. PMC 471250. PMID 6770485.
^ Craft, Alan (December 13, 2011). "John Scott Inkster". BMJ (obituary) 343: D7517. doi:10.1136/bmj.d7517.

External links

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 呼気終末陽圧（PEEP） positive end expiratory pressure peep
2. 機械的人工換気の概要 overview of mechanical ventilation
3. 成人の急性呼吸窮迫症候群における機械的人工換気 mechanical ventilation of adults in acute respiratory distress syndrome
4. 機械的人工換気の生理学的および病理生理学的転帰 physiologic and pathophysiologic consequences of mechanical ventilation
5. Noninvasive ventilation for acute and impending respiratory failure in children

English Journal

Positive end-expiratory pressure titration at bedside using electrical impedance tomography in post-operative cardiac surgery patients.

Karsten J1, Grusnick C2, Paarmann H2, Heringlake M2, Heinze H2.
Acta anaesthesiologica Scandinavica.Acta Anaesthesiol Scand.2015 Jul;59(6):723-32. doi: 10.1111/aas.12518. Epub 2015 Apr 13.
BACKGROUND: Post-operative positive end-expiratory pressure (PEEP) setting to minimize the risk of ventilator-associated lung injury is still controversial. Assessment of regional ventilation distribution by electrical impedance tomography (EIT) might be superior as compared with global parameters.
PMID 25867049

Effects of lipopolysaccharide-induced inflammation on initial lung fibrosis during open-lung mechanical ventilation in rats.

Krebs J1, Kolz A2, Tsagogiorgas C3, Pelosi P4, Rocco PR5, Luecke T6.
Respiratory physiology & neurobiology.Respir Physiol Neurobiol.2015 Jul;212-214:25-32. doi: 10.1016/j.resp.2015.04.003. Epub 2015 Apr 9.
This study aimed to assess the impact of pulmonary inflammation on early fibrotic response in rats challenged with increasing doses of lipopolysaccharide (LPS). Twenty-four rats were randomized and infused with three different increasing doses of continuous LPS infusion (n=8/group) while being venti
PMID 25864801

Biological Impact of Transpulmonary Driving Pressure in Experimental Acute Respiratory Distress Syndrome.

Samary CS1, Santos RS, Santos CL, Felix NS, Bentes M, Barboza T, Capelozzi VL, Morales MM, Garcia CS, Souza SA, Marini JJ, de Abreu MG, Silva PL, Pelosi P, Rocco PR.
Anesthesiology.Anesthesiology.2015 Jun 3. [Epub ahead of print]
BACKGROUND: Ventilator-induced lung injury has been attributed to the interaction of several factors: tidal volume (VT), positive end-expiratory pressure (PEEP), transpulmonary driving pressure (difference between transpulmonary pressure at end-inspiration and end-expiration, ΔP,L), and respiratory
PMID 26039328

Japanese Journal

Extracorporeal membrane oxygenationにより救命しえた新型インフルエンザによる呼吸不全の1例

仁科雅良/佐藤孝幸/石井真佐隆/須賀弘泰/横山利光/西久保俊士/増田崇光/中川隆雄
東京女子医科大学雑誌 81(5), 377-380, 2011-10-25
今回われわれは、Extracorporeal membrane oxygenation (ECMO) により救命しえた新型インフルエンザによる呼吸不全の1例を経験したので報告する。患者は59歳、男性。咳と発熱が出現した。翌日近医へ入院した。インフルエンザ簡易検査が陰性だったので抗菌薬を投与された。2日後、呼吸状態が悪化した。簡易検査が陽性となったので、ラニナミビルを吸入した。当センターへ紹介・搬送 …
NAID 110008672491

人工換気療法 (特集急性脳炎・脳症の概念) -- (急性脳炎・脳症の予防・治療)

濱田哲,石川悠加,石川幸辰 [他]
日本臨床 69(3), 520-524, 2011-03
NAID 40018729437

Related Pictures

★リンクテーブル★

リンク元	「呼気終末陽圧」「positive-pressure respiration」
関連記事	「end」「positive」「expiratory」「ending」「pressure」

「呼気終末陽圧」

　　[★]

英: positive end-expiratory pressure、PEEP
関: 終末呼気陽圧、呼気終末陽圧換気、陽圧換気、終末呼気陽圧、ピープ

[show details]

呼気終末陽圧 : 約 15,900 件
終末呼気陽圧 : 約 6,160 件
呼気終末陽圧換気 : 44 件
終末呼気陽圧換気 : 23 件

呼気の間に気道に陽圧をかけ、気道や肺胞の虚脱を防ぐ。
陽圧にすることで換気量がいくらかが減少する？？わけで、機能的残気量が減少する
虚脱しなかった肺胞を介するガス交換により、シャントが減少させる効果がある？？
デメリット：肺胞が呼気中でも十分に拡張したままであるので、肺の毛細血管が圧迫され、肺の血管抵抗が上昇する。この結果として低心拍出量をきたす。

「positive-pressure respiration」

　　[★]

(気道に陽圧を適用して肺胞換気を促進させる方法)陽圧呼吸、陽圧換気、陽圧呼吸法、陽圧換気法

関: PEEP、positive end-expiratory pressure、positive-pressure breathing

「end」

　　[★]

n.

終わり、末端、端、目標

v.

終了する、終わる

関: aim、brink、cease、complete、conclude、corner、distal、eventuate、extremity、goal、object、objective、side、terminal、terminally、terminate、termination

「positive」

　　[★]

adj.

陽性の、正の、積極的な、ポジティブな

関: active、actively、aggressive、offensive、positively、positivity

「expiratory」

　　[★]

adj.

呼気性の、呼息の

関: exhalation、exhale、expiration

「ending」

　　[★]

n.

終末

関: terminal、terminally

「pressure」

　　[★]

n.

圧力

[1] "Positive end-expiratory pressure (PEEP)". TheFreeDictionary.com. Citing: Saunders Comprehensive Veterinary Dictionary. 2007.

[pmid16003057-2] Caramez, MP; Borges, JB; Tucci, MR; Okamoto, VN; et al. (2005). "Paradoxical responses to positive end-expiratory pressure in patients with airway obstruction during controlled ventilation". Crit Care Med 33 (7): 1519–28. doi:10.1097/01.CCM.0000168044.98844.30. PMC 2287196. PMID 16003057.

[pmid3053583-3] Smith, TC; Marini, JJ (1988). "Impact of PEEP on lung mechanics and work of breathing in severe airflow obstruction". J Appl Physiol 65 (4): 1488–99. PMID 3053583.

[pmid15054570-4] Kondili, E; Alexopoulou, C; Prinianakis, G; Xirouchaki, N; et al. (2004). "Pattern of lung emptying and expiratory resistance in mechanically ventilated patients with chronic obstructive pulmonary disease". Intensive Care Med 30 (7): 1311–8. doi:10.1007/s00134-004-2255-z. PMID 15054570.

[pmid18664777-5] Manzano, F; Fernández-Mondéjar, E; Colmenero, M; Poyatos, ME; et al. (2008). "Positive-end expiratory pressure reduces incidence of ventilator-associated pneumonia in nonhypoxemic patients". Crit Care Med 36 (8): 2225–31. doi:10.1097/CCM.0b013e31817b8a92. PMID 18664777.

[6] Smith, RA (1988). "Physiologic PEEP". Respir Care 33: 620.

[pmid327031-7] Frost, EA (1977). "Effects of positive end-expiratory pressure on intracranial pressure and compliance in brain-injured patients". J Neurosurg 47 (2): 195–200. doi:10.3171/jns.1977.47.2.0195. PMID 327031.

[8] Caricato, A; Conti, G; Della Corte, F; Mancino, A; et al. (March 2005). "Effects of PEEP on the intracranial system of patients with head injury and subarachnoid hemorrhage: The role of respiratory system compliance". The Journal of Trauma and Acute Care Surgery 58 (3): 571–6. doi:10.1097/01.ta.0000152806.19198.db. PMID 15761353.

[9] Oliven, A; Taitelman, U; Zveibil, F; Bursztein, S (March 1980). "Effect of positive end-expiratory pressure on intrapulmonary shunt at different levels of fractional inspired oxygen". Thorax 35 (3): 181–5. doi:10.1136/thx.35.3.181. PMC 471250. PMID 6770485.

[10] Craft, Alan (December 13, 2011). "John Scott Inkster". BMJ (obituary) 343: D7517. doi:10.1136/bmj.d7517.

匿名

検索

案内

案内

positive end-expiratory pressure