Document Detail


Cardiovascular effects of ventilation with positive expiratory airway pressure.
MedLine Citation:
PMID:  7034659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The broad clinical application of positive and expiratory pressure (PEEP) in the treatment of a variety of respiratory disorders has led to the observation that positive airway pressure can result in cardiac dysfunction. Recent attempts to integrate and extend the results of past research have led to diverse explanations of the overall cardiopulmonary effects of PEEP. This review summarizes previous work in the field and attempts to explain the basis of the divergent conclusions of previous investigators. Data are presented from several experimental models, as well as studies in postoperative patients to formulate an overall analysis of the influence of airway pressure on the central circulation. It appears that the effects of PEEP are primarily mechanical and are mediated through a combination of right ventricular preload limitation and outflow obstruction. Both effects are additive in limiting left ventricular preload and can be ameliorated by volume loading in the absence of significant right ventricular or pulmonary vascular disease. Neural, humoral and ventricular interactive forces appear to be insignificant under most circumstances. The clinical implications of these advances in the current understanding of PEEP are reviewed.
Authors:
P K Smith; G S Tyson; J W Hammon; C O Olsen; R A Hopkins; G W Maier; D C Sabiston; J S Rankin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of surgery     Volume:  195     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1982 Feb 
Date Detail:
Created Date:  1982-03-26     Completed Date:  1982-03-26     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  121-30     Citation Subset:  AIM; IM; S    
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Pressure
Cardiac Volume
Dogs
Heart / physiology*
Hemodynamics*
Humans
Positive-Pressure Respiration / adverse effects*
Pressure
Pulmonary Artery / physiology
Pulmonary Ventilation
Stroke Volume
Grant Support
ID/Acronym/Agency:
2R01-HL09315-17/HL/NHLBI NIH HHS; HL 22332/HL/NHLBI NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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