Document Detail

Effects of positive end-expiratory pressure ventilation on cerebral venous pressure with head elevation in dogs.
MedLine Citation:
PMID:  10658034     Owner:  NLM     Status:  MEDLINE    
Mechanical ventilation with positive end-expiratory pressure (PEEP) may prevent venous air embolism in the sitting position because cerebral venous pressure (Pcev) could be increased by the PEEP-induced increase in right atrial pressure (Pra). Whereas it is clear that there is a linear transmission of the PEEP-induced increase in Pra to Pcev while the dog is in the prone position, the mechanism of the transmission with the dog in the head-elevated position is unclear. We tested the hypothesis that a Starling resistor-type mechanism exists in the jugular veins when the head is elevated. In one group of dogs, increasing PEEP linearly increased Pcev with the dog in the prone position (head at heart level, slope = 0.851) but did not increase Pcev when the head was elevated. In another group of dogs, an external chest binder was used to produce a larger PEEP-induced increase in Pra. Further increasing Pra increased Pcev only after Pra exceeded a pressure of 19 mmHg (break pressure). This sharp inflection in the upstream (Pcev)-downstream (Pra) relationship suggests that this may be caused by a Starling resistor-type mechanism. We conclude that jugular venous collapse serves as a significant resistance in the transmission of Pra to Pcev in the head-elevated position.
T J Toung; H Aizawa; R J Traystman
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  88     ISSN:  8750-7587     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-03-03     Completed Date:  2000-03-03     Revised Date:  2013-09-26    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  655-61     Citation Subset:  IM; S    
Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-7834, USA.
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MeSH Terms
Atrial Function
Blood Pressure / physiology*
Cerebral Veins / physiology*
Cerebrospinal Fluid Pressure
Intracranial Pressure
Jugular Veins / physiology
Positive-Pressure Respiration*
Posture / physiology*
Grant Support

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

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