Document Detail

Oxygen consumption and PEEPe in ventilated COPD patients.
MedLine Citation:
PMID:  15766900     Owner:  NLM     Status:  MEDLINE    
The intrinsic positive-end-expiratory pressure (PEEPi) increases the inspiratory load, the cost of breathing and thus oxygen consumption (V(O2)). It has been shown that applying an extrinsic positive-end-expiratory pressure (PEEPe) reduces the inspiratory threshold load but the optimal PEEPe level is still in debate. We hypothesize that the best level of PEEPe could induce a decrease in V(O2) by reducing the V(O2) demands from PEEPi. Nine mechanically ventilated COPD patients were included. The level of PEEPe was determined in accordance with the static PEEPi. V(O2) was measured using an automatic gas analyser during synchronized intermittent mandatory ventilation (SIMV): without PEEPe, with a PEEPe equal to 50% of static PEEPi and with a PEEPe equal to 100% of static PEEPi. Static PEEPi appeared to be significantly correlated with the degree of airflow obstruction (FEV1) (P<0.05). Applying a PEEPe equal to static PEEPi resulted in a significant decrease in V(O2) (P<0.05) whereas the change in V(O2) proved to be unpredictable for a PEEPe level of 50% of static PEEPi. In conclusion, V(O2) decreases progressively when increasing PEEPe up to a level equal to 100% of static PEEPi. Thus, in mechanically ventilated COPD patients with a FEV1 < or = 1000 ml, applying a PEEPe of 5 cmH2O should be recommended.
J-Ch Glérant; O Leleu; D Rose; I Mayeux; V Jounieaux
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Respiratory physiology & neurobiology     Volume:  146     ISSN:  1569-9048     ISO Abbreviation:  Respir Physiol Neurobiol     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-15     Completed Date:  2005-05-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101140022     Medline TA:  Respir Physiol Neurobiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  117-24     Citation Subset:  IM    
Respiratory Department and Intensive Care Unit, 80054 Amiens Cedex 1, France.
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MeSH Terms
Lung Volume Measurements
Middle Aged
Oxygen Consumption / physiology*
Positive-Pressure Respiration*
Positive-Pressure Respiration, Intrinsic / physiopathology*
Pulmonary Disease, Chronic Obstructive / physiopathology*
Pulmonary Ventilation
Respiratory Function Tests
Ventilators, Mechanical

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