Auto-PEEP is auto positive end-expiratory pressure due to excessive amounts of alveolar gas produced by sustained recurrent incomplete exhalation. Incomplete exhalation occurs when the exhaled breath never reaches a flow rate of 0 L/min. The objective of this dissertation is to develop an automated detection system of auto-PEEP through incomplete exhalation as revealed by ventilator graphics for mechanically ventilated adults. Auto-PEEP can cause adverse effects if allowed to linger and if not quickly identified. An automated detection system will be instrumental in helping to quickly identify auto-PEEP. A computerized algorithm was developed to detect incomplete exhalation based on the following three parameters:1) Foi, was used to represent the value of the flow at the onset of inhalation, 2) ∆T, was used to represent the value of time difference between onset inhalation to the 0 L/min mark, and 3) slope threshold, a value set for the slope of change of flow over ∆T. Optimum parameters of the algorithm were achieved for Foi = -3 L/min, ∆T = 0.2 s, and slope threshold = 90 L-s/min. A novel data set was introduced to validate the algorithm, yielding no significant difference in true positive rates (t = 1.5, df = 12.402, p-value = 0.1408) and false positive rates (t = 1.9, df = 16.765, p-value = 0.0725) as outcomes for two-tailed t-tests comparing the novel and old data set. To determine the relationship between auto-PEEP and detection of sustained incomplete exhalation, a correlation of a linear model of the novel data set between auto-PEEP and the percentage of incomplete exhalation detection out of the existing breaths (index) was investigated. A linear model should interpret the index value that corresponds to significant auto-PEEP presence; unfortunately, no significant linear model was found between incomplete exhalation index and auto-PEEP (F1,62 = 1.67, p-value = 0.2010). However, there was a relationship between the intrinsic PEEP values and the incomplete exhalation index as functions of time. The automated detection algorithm produced by this work provides a non-invasive method of automatically detecting auto-PEEP.
","abstract_html":"<p>Auto-PEEP is auto positive end-expiratory pressure due to excessive amounts of alveolar gas produced by sustained recurrent incomplete exhalation. Incomplete exhalation occurs when the exhaled breath never reaches a flow rate of 0 L/min. The objective of this dissertation is to develop an automated detection system of auto-PEEP through incomplete exhalation as revealed by ventilator graphics for mechanically ventilated adults. Auto-PEEP can cause adverse effects if allowed to linger and if not quickly identified. An automated detection system will be instrumental in helping to quickly identify auto-PEEP. A computerized algorithm was developed to detect incomplete exhalation based on the following three parameters:1) Foi, was used to represent the value of the flow at the onset of inhalation, 2) ∆T, was used to represent the value of time difference between onset inhalation to the 0 L/min mark, and 3) slope threshold, a value set for the slope of change of flow over ∆T. Optimum parameters of the algorithm were achieved for Foi = -3 L/min, ∆T = 0.2 s, and slope threshold = 90 L-s/min. A novel data set was introduced to validate the algorithm, yielding no significant difference in true positive rates (t = 1.5, df = 12.402, p-value = 0.1408) and false positive rates (t = 1.9, df = 16.765, p-value = 0.0725) as outcomes for two-tailed t-tests comparing the novel and old data set. To determine the relationship between auto-PEEP and detection of sustained incomplete exhalation, a correlation of a linear model of the novel data set between auto-PEEP and the percentage of incomplete exhalation detection out of the existing breaths (index) was investigated. A linear model should interpret the index value that corresponds to significant auto-PEEP presence; unfortunately, no significant linear model was found between incomplete exhalation index and auto-PEEP (F1,62 = 1.67, p-value = 0.2010). However, there was a relationship between the intrinsic PEEP values and the incomplete exhalation index as functions of time. The automated detection algorithm produced by this work provides a non-invasive method of automatically detecting auto-PEEP.</p>","abstract_has_math":false,"creators":["Arief, Nyimas"],"institution":null,"degree_name":"Doctor of Philosophy","degree_level":"Dissertation","degree_discipline":"Biomedical Engineering","degree_department":null,"school":null,"contributors":["Paul Wetzel"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2013,"date_issued":"2013-01-01T08:00:00Z","date_published":"2013-01-01T08:00:00Z","updated_at":"2026-07-24T05:54:02Z","subjects":["Mechanical Ventilator","Auto-PEEP","Patient Ventilator Asynchrony","Algorithm","Ventilator Graphic","Intrinsic PEEP","Detection","Automated","Biomedical Engineering and Bioengineering","Engineering"],"languages":[],"rights":["© The Author"],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["https://scholarscompass.vcu.edu/etd/534"],"render_values":[{"text":"https://scholarscompass.vcu.edu/etd/534","href":"https://scholarscompass.vcu.edu/etd/534","code":true}]}]},"links":{"outbound_url":"https://doi.org/10.25772/BAND-NY10","outbound_label":"DOI","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Paul Wetzel"]},{"key":"dc:creator","label":"Author","values":["Arief, Nyimas"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2018-08-14T07:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Biomedical Engineering"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Dissertation"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Philosophy"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Mechanical Ventilator","Auto-PEEP","Patient Ventilator Asynchrony","Algorithm","Ventilator Graphic","Intrinsic PEEP","Detection","Automated","Biomedical Engineering and Bioengineering","Engineering"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["© The Author"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://doi.org/10.25772/BAND-NY10","https://scholarscompass.vcu.edu/etd/534"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Auto-PEEP is auto positive end-expiratory pressure due to excessive amounts of alveolar gas produced by sustained recurrent incomplete exhalation. Incomplete exhalation occurs when the exhaled breath never reaches a flow rate of 0 L/min. The objective of this dissertation is to develop an automated detection system of auto-PEEP through incomplete exhalation as revealed by ventilator graphics for mechanically ventilated adults. Auto-PEEP can cause adverse effects if allowed to linger and if not quickly identified. An automated detection system will be instrumental in helping to quickly identify auto-PEEP. A computerized algorithm was developed to detect incomplete exhalation based on the following three parameters:1) Foi, was used to represent the value of the flow at the onset of inhalation, 2) ∆T, was used to represent the value of time difference between onset inhalation to the 0 L/min mark, and 3) slope threshold, a value set for the slope of change of flow over ∆T. Optimum parameters of the algorithm were achieved for Foi = -3 L/min, ∆T = 0.2 s, and slope threshold = 90 L-s/min. A novel data set was introduced to validate the algorithm, yielding no significant difference in true positive rates (t = 1.5, df = 12.402, p-value = 0.1408) and false positive rates (t = 1.9, df = 16.765, p-value = 0.0725) as outcomes for two-tailed t-tests comparing the novel and old data set. To determine the relationship between auto-PEEP and detection of sustained incomplete exhalation, a correlation of a linear model of the novel data set between auto-PEEP and the percentage of incomplete exhalation detection out of the existing breaths (index) was investigated. A linear model should interpret the index value that corresponds to significant auto-PEEP presence; unfortunately, no significant linear model was found between incomplete exhalation index and auto-PEEP (F1,62 = 1.67, p-value = 0.2010). However, there was a relationship between the intrinsic PEEP values and the incomplete exhalation index as functions of time. The automated detection algorithm produced by this work provides a non-invasive method of automatically detecting auto-PEEP.
"]},{"key":"dc:title","label":"Title","values":["Automated Detection of Incomplete Exhalation as an Indirect Detection of Auto-PEEP on Mechanically Ventilated Adults"]}]}],"canonical_facts":{"dc:contributor":["Paul Wetzel"],"dc:creator":["Arief, Nyimas"],"dc:date.available":["2018-08-14T07:00:00Z"],"dc:description.abstract":["Auto-PEEP is auto positive end-expiratory pressure due to excessive amounts of alveolar gas produced by sustained recurrent incomplete exhalation. Incomplete exhalation occurs when the exhaled breath never reaches a flow rate of 0 L/min. The objective of this dissertation is to develop an automated detection system of auto-PEEP through incomplete exhalation as revealed by ventilator graphics for mechanically ventilated adults. Auto-PEEP can cause adverse effects if allowed to linger and if not quickly identified. An automated detection system will be instrumental in helping to quickly identify auto-PEEP. A computerized algorithm was developed to detect incomplete exhalation based on the following three parameters:1) Foi, was used to represent the value of the flow at the onset of inhalation, 2) ∆T, was used to represent the value of time difference between onset inhalation to the 0 L/min mark, and 3) slope threshold, a value set for the slope of change of flow over ∆T. Optimum parameters of the algorithm were achieved for Foi = -3 L/min, ∆T = 0.2 s, and slope threshold = 90 L-s/min. A novel data set was introduced to validate the algorithm, yielding no significant difference in true positive rates (t = 1.5, df = 12.402, p-value = 0.1408) and false positive rates (t = 1.9, df = 16.765, p-value = 0.0725) as outcomes for two-tailed t-tests comparing the novel and old data set. To determine the relationship between auto-PEEP and detection of sustained incomplete exhalation, a correlation of a linear model of the novel data set between auto-PEEP and the percentage of incomplete exhalation detection out of the existing breaths (index) was investigated. A linear model should interpret the index value that corresponds to significant auto-PEEP presence; unfortunately, no significant linear model was found between incomplete exhalation index and auto-PEEP (F1,62 = 1.67, p-value = 0.2010). However, there was a relationship between the intrinsic PEEP values and the incomplete exhalation index as functions of time. The automated detection algorithm produced by this work provides a non-invasive method of automatically detecting auto-PEEP.
"],"dc:identifier":["https://doi.org/10.25772/BAND-NY10","https://scholarscompass.vcu.edu/etd/534"],"dc:rights":["© The Author"],"dc:subject":["Mechanical Ventilator","Auto-PEEP","Patient Ventilator Asynchrony","Algorithm","Ventilator Graphic","Intrinsic PEEP","Detection","Automated","Biomedical Engineering and Bioengineering","Engineering"],"dc:title":["Automated Detection of Incomplete Exhalation as an Indirect Detection of Auto-PEEP on Mechanically Ventilated Adults"],"thesis:degree_discipline":["Biomedical Engineering"],"thesis:degree_level":["Dissertation"],"thesis:degree_name":["Doctor of Philosophy"]},"updated_at":"2026-07-24T05:54:02Z"}