Document Detail

Effects of PEEP on liver arterial and venous blood flows.
MedLine Citation:
PMID:  7633699     Owner:  NLM     Status:  MEDLINE    
Total venous return decreases with positive end-expiratory pressure (PEEP). It is likely that the liver plays an important role in this response, either through the development of an increase in venous resistance or through an increase in the venous backpressure at the outflow end of the liver. In addition, hepatic arterial flow is reported to be selectively decreased by the application of PEEP. Therefore, to clarify the effects of PEEP on liver hemodynamics, we generated pressure-flow (P-Q) relationships in both liver vascular beds of anesthetized, mechanically ventilated pigs at PEEP of 0, 5, 10, and 15 cm H2O to obtain values of backpressure (Pback, mm Hg) from linear extrapolation of the P-Q relationships and resistance (mm Hg/ml/min/kg) from its slope. PEEP decreased portal vein flow (Qpv) and caused an increase in the liver venous resistance (from 0.08 +/- 0.01 to 0.16 +/- 0.02 mm Hg/ml/min/kg; p < 0.05). Ppvback and right atrial pressure (Pra) increased equally (from 5.1 +/- 0.3 to 9.9 +/- 0.4 mm Hg, p < 0.05, and from 4.0 +/- 0.2 to 8.6 +/- 0.5 mm Hg, p < 0.05, respectively, at PEEP 15). The reduction in portal venous flow was related to an increase in the backpressure to flow (as a result of an increase in Pra) and to an increase in liver venous resistances that may cause blood pooling in the splanchnic compartment and decrease venous return through the liver. PEEP increased Phaback (from 11.2 +/- 0.9 to 14.5 +/- 0.7 mm Hg at PEEP 15, p < 0.05) but did not change hepatic arterial resistance.(ABSTRACT TRUNCATED AT 250 WORDS)
N Brienza; J P Revelly; T Ayuse; J L Robotham
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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:  American journal of respiratory and critical care medicine     Volume:  152     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1995-09-14     Completed Date:  1995-09-14     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  504-10     Citation Subset:  AIM; IM    
Department of Anesthesia and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21287-4965, USA.
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MeSH Terms
Atrial Function, Right
Blood Pressure
Blood Volume
Cardiac Output
Hepatic Artery / physiology*
Hepatic Veins / physiology*
Liver Circulation*
Plasma Substitutes / pharmacology
Portal Pressure
Portal Vein / physiology
Positive-Pressure Respiration*
Splanchnic Circulation
Vascular Resistance
Grant Support
Reg. No./Substance:
0/Plasma Substitutes

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

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