Pediatric Simulation of Intrinsic PEEP and Patient-Ventilator Trigger Asynchrony During Mechanical Ventilation.

A passive lung model describes the development of increasing intrinsic PEEP with increasing R at a given ventilator breathing rate. An active lung model shows how this can lead to trigger asynchrony since the P needed to trigger a breath is greater with increased R, as the inspiratory muscles must overcome intrinsic PEEP. This model will lend itself to the study of intrinsic PEEP engendered by a higher ventilator breathing rate, as well as higher T/T, and will be useful in ventilator simulation scenarios of PVA. The model also suggests that increasing ventilator PEEP to match intrinsic PEEP can improve trigger asynchrony through a reduction in R.