Document Detail

Left ventricular geometry during positive end-expiratory pressure in dogs.
MedLine Citation:
PMID:  3893886     Owner:  NLM     Status:  MEDLINE    
We evaluated changes in left ventricular (LV) geometry in ten dogs during intermittent positive-pressure ventilation (IPPV) with and without 10 cm H2O of positive end-expiratory pressure (PEEP). The dimensions during expiration and inspiration decreased in all three orthogonal axes during PEEP, consistent with decreased LV end-diastolic (ED) and end-systolic (ES) volumes. Within a respiratory cycle, the anterior-posterior (AP) ED dimension during inspiration increased with IPPV alone but decreased when PEEP was added, consistent with presumed differences in pulmonary venous return. This caused opposite changes in AP percent regional shortening. Septal-lateral free wall (SL) percent regional shortening decreased during inspiration with both IPPV and PEEP, but the respiratory variation was significantly less during PEEP. Thus, PEEP did not simply produce a smaller version of the same events seen during IPPV alone. The larger decreases with PEEP observed in ED compared to ES dimensions in the AP and SL axes suggest a dominant regional preload effect, whereas the larger fall in the long axis ES compared to ED dimension suggests a primary regional decrease in afterload. Measurements of the right ventricular SL axis in three dogs showed an overall reduction with PEEP, with the inspiratory dimensions being minimal during both IPPV alone and with PEEP. Thus, ventricular interdependence cannot account for the diminished LV SL dimension with PEEP during any part of the respiratory cycle. These findings suggest that the motion of the LV free wall influenced by changes in lung volume may be at least as important as septal motion in determining LV geometry with PEEP.(ABSTRACT TRUNCATED AT 250 WORDS)
J L Robotham; R C Bell; F R Badke; M K Kindred
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Critical care medicine     Volume:  13     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1985 Aug 
Date Detail:
Created Date:  1985-08-30     Completed Date:  1985-08-30     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  617-24     Citation Subset:  AIM; IM    
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MeSH Terms
Blood Pressure
Heart / physiology*
Heart Rate
Intermittent Positive-Pressure Ventilation
Lung Volume Measurements
Positive-Pressure Respiration*
Stroke Volume
Ventricular Function
Grant Support

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