| Effects of positive end-expiratory pressure ventilation on splanchnic oxygenation in humans. | |
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MedLine Citation:
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PMID: 8841866 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To examine the influence of positive end-expiratory pressure (PEEP) ventilation on splanchnic oxygenation and lactate production in humans without pulmonary disorders. DESIGN: Prospective study. SETTING: Single-institutional surgical intensive care unit in a university hospital. PARTICIPANTS: Twenty patients who underwent major abdominal surgery. INTERVENTIONS: Radial artery, pulmonary artery, and right hepatic vein catheters. Blood samples were collected to determine lactate concentrations and oxygen saturations. MEASUREMENTS AND MAIN RESULTS: Six hours postoperatively PEEP levels (5, 10, and 15 cmH2O) were applied in a randomized order, and the following parameters were determined before and at the end of each PEEP level: cardiac output (CO); mean arterial pressure (MAP); arterial (SaO2), mixed venous (SvO2) and hepatic venous oxygen saturation (ShvO2); systemic (C[a-v]O2) and splanchnic (C[a-hv]O2) arterial venous oxygen content difference; and arterial, mixed venous, and hepatic venous lactate concentration. CO and MAP were reduced at PEEP 10 and 15 cmH2O, accompanied by a decrease in SvO2 but unchanged SaO2. A decrease in ShvO2 was seen at PEEP 15 cmH2O. C(a-v)O2 and C(a-hv)O2 were increased at PEEP 15 cmH2O. However, at PEEP 15 cmH2O, the percent increment in C(a-hv)O2 was greater than the increment in C(a-v)O2. Lactate concentrations remained unchanged. CONCLUSIONS: Ventilation with PEEP causes reductions in CO and MAP, resulting in a comparable impairment of systemic and splanchnic oxygen. The absence of changes in lactate concentrations indicates that a critical reduction in systemic and splanchnic oxygenation is unlikely during ventilation with low or high PEEP levels. |
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Authors:
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E Berendes; G Lippert; H M Loick; T Brüssel |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of cardiothoracic and vascular anesthesia Volume: 10 ISSN: 1053-0770 ISO Abbreviation: J. Cardiothorac. Vasc. Anesth. Publication Date: 1996 Aug |
Date Detail:
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Created Date: 1996-12-19 Completed Date: 1996-12-19 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9110208 Medline TA: J Cardiothorac Vasc Anesth Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 598-602 Citation Subset: IM |
Affiliation:
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Klinik und Poliklinik für Anaesthesiologie, Westfälische Wilhelms-Universität, Münster, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Hemodynamics Humans Lactic Acid / blood Liver Circulation Male Middle Aged Oxygen / blood* Positive-Pressure Respiration* Prospective Studies Splanchnic Circulation* |
| Chemical | |
Reg. No./Substance:
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50-21-5/Lactic Acid; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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