Detrimental effects of auto-positive end expiratory pressure (PEEP) include which of the fol-lowing?
1. Increased work of breathing
2. Increased pulmonary barotrauma
3. Decreased pulmonary vascular resistance
4. Increased venous return
a. 1 and 2 only
b. 1, 2, and 3 only
c. 3 and 4 only
d. 2, 3, and 4 only
ANS: A
By increasing FRC and alveolar pressure, auto-PEEP increases the risk and severity of barotrau-ma and volutrauma. Auto-PEEP also increases the work of breathing and impedes venous return, the result being a decrease in cardiac output. Auto-PEEP also can increase pulmonary vascular resistance.
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