Document Detail


Effects of positive end-expiratory pressure ventilation on splanchnic oxygenation in humans.
MedLine Citation:
PMID:  8841866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
E Berendes; G Lippert; H M Loick; T Brüssel
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  10     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1996-12-19     Completed Date:  1996-12-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  598-602     Citation Subset:  IM    
Affiliation:
Klinik und Poliklinik für Anaesthesiologie, Westfälische Wilhelms-Universität, Münster, Germany.
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MeSH Terms
Descriptor/Qualifier:
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:
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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