Auto-PEEP (end-expiratory hold)
Computes auto-PEEP from an end-expiratory hold: the total PEEP read during the hold minus the PEEP set on the ventilator.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- PEEP set on the ventilator
- 5 cmH2O
- Total PEEP, from an end-expiratory hold
- 13 cmH2O
- Plateau pressure, to see the effect on the driving pressure
- 30 cmH2O
- The patient was passive for the hold
- Yes
- Expiratory flow does not return to zero before the next breath
- No
Result: auto-PEEP of 8, and a driving pressure overstated by that same 8 if the set PEEP is used
The tool opens with these values already filled in. Replace them with your own.
What the result means
- The measurement
- Total PEEP read during an end-expiratory hold, minus the PEEP set on the ventilator.
- It needs
- A passive patient. Expiratory effort raises the pressure read and inspiratory effort lowers it.
- A measured zero
- Does not exclude gas trapping. Where airways collapse, the trapped gas never reaches the circuit during the hold.
- The sign that survives
- Expiratory flow failing to return to zero before the next breath.
- Driving pressure
- Plateau minus TOTAL PEEP. Using the set PEEP overstates it by exactly the auto-PEEP.
- Triggering
- The patient must generate all of the auto-PEEP before any flow reaches the sensor, which is where missed triggers come from.
What you enter
- PEEP set on the ventilator
- Total PEEP, from an end-expiratory hold
- Plateau pressure, to see the effect on the driving pressure
- The patient was passive for the hold
- Expiratory flow does not return to zero before the next breath
How this is calculated
Pepe PE, Marini JJ. Occult positive end-expiratory pressure in mechanically ventilated patients with airflow obstruction: the auto-PEEP effect. Am Rev Respir Dis. 1982;126(1):166-170. Blanch L, Bernabe F, Lucangelo U. Respir Care. 2005;50(1):110-123. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.