| Hemodynamic effects of positive end-expiratory pressure during abdominal hyperpression: A preliminary study in healthy volunteers. | |
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MedLine Citation:
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PMID: 21514092 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: An increase in abdominal pressure induces an increase in left ventricular afterload under clinical conditions. We tested the hypothesis that positive end-expiratory pressure (PEEP) could reverse the hemodynamic consequences of abdominal hyperpression by opposing the increase in left ventricular afterload. MATERIALS AND METHODS: Eight healthy volunteers were investigated during 3 experimental conditions: (1) baseline, (2) increase in abdominal pressure by means of medical antishock trousers (MAST) inflation, and (3) addition of PEEP +10 cm H(2)O. Heart loading conditions and left ventricular systolic and diastolic function were assessed by transthoracic echocardiography. RESULTS: The application of PEEP significantly reduced the prior increase in end-systolic wall stress: 45 ± 11 vs 55 ± 14 kdyn/cm(2), P < .05. Medical antishock trousers inflation significantly altered the deceleration time of mitral E wave: 199 ± 23 vs 156 ± 38 milliseconds, P < .05. Left ventricular preload and global systolic performance were unaffected by MAST and PEEP applications. CONCLUSIONS: The increase in left ventricular afterload induced by MAST inflation can be efficiently reduced by the use of a moderate PEEP. Potential clinical applications in the abdominal compartment syndrome or in the setting of laparoscopic surgery should be developed. |
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Authors:
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Jean-Luc Fellahi; Vincent Caille; Cyril Charron; Georges Daccache; Antoine Vieillard-Baron |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-20 |
Journal Detail:
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Title: Journal of critical care Volume: - ISSN: 1557-8615 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8610642 Medline TA: J Crit Care Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Caen, France; Univ Caen, Faculty of Medicine, Caen, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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