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In respiratory therapy or mechanical ventilation, the ratio of a patient's inspiratory to expiratory time.
The haemodynamic effects associated with auto-PEEP are well known, and the clinician should be aware of them and monitor them. In the presence of a known haemodynamic impairment, such as a decreased cardiac index (as was observed in the study by Vieillard-Baron and coworkers ), the clinician has several choices. If the priority is to limit ventilator-induced lung injury, and we persist on a low Vt strategy, then the use of a higher respiratory rate appears unavoidable if we are to maintain acceptable PCO2 and pH levels. To limit auto-PEEP, we can try to increase the expiratory time by increasing the inspiratory flow rate and decreasing the plateau time. However, a reduction in inspiratory time and in the ratio of inspiratory to expiratory time.