Document Detail

Ventilation and perfusion distribution during altered PEEP in the left lung in the left lateral decubitus posture with unchanged tidal volume in dogs.
MedLine Citation:
PMID:  16830789     Owner:  NLM     Status:  MEDLINE    
Previous studies in anesthetized humans positioned in the left lateral decubitus (LLD) posture have shown that unilateral positive end-expiratory pressure (PEEP) to the dependent lung produce a more even ventilation distribution and improves gas exchange. Unilateral PEEP to the dependent lung may offer special advantages during LLD surgery by reducing the alveolar-to-arterial oxygen pressure difference {(A-a)PO2 or venous admixture} in patients with thoracic trauma or unilateral lung injury. We measured the effects of unilateral PEEP on regional distribution of blood flow (Q) and ventilation (V(A)) using fluorescent microspheres in pentobarbital anesthetized and air ventilation dogs in left lateral decubitus posture with synchronous lung inflation. Tidal volume to left and right lung is maintained constant to permit the effect on gas exchange to be examined. The addition of unilateral PEEP to the left lung increased its FRC with no change in left-right blood flow distribution or venous admixture. The overall lung V(A)/Q distribution remained relatively constant with increasing unilateral PEEP. Bilateral PEEP disproportionately increased FRC in the right lung but again produced no significant changes in venous admixture or V(A)/Q distribution. We conclude that the reduced dependent lung blood flow observed without PEEP occurs secondary to a reduction in lung volume. When tidal volume is maintained, unilateral PEEP increases dependent lung volume with little effect of perfusion distribution maintaining gas exchange.
Hung Chang; Stephen J Lai-Fook; Karen B Domino; Jack Hildebrandt; H Thomas Robertson; Robb W Glenny; Jane-Yi Hsu; Shih-Chun Lee; Michael P Hlastala
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Chinese journal of physiology     Volume:  49     ISSN:  0304-4920     ISO Abbreviation:  Chin J Physiol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-07-11     Completed Date:  2006-08-16     Revised Date:  2009-08-12    
Medline Journal Info:
Nlm Unique ID:  7804502     Medline TA:  Chin J Physiol     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  74-82     Citation Subset:  IM    
Department of Physiology and Biophysics, University of Washington, Seattle, Washington 98195, USA.
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MeSH Terms
Adaptation, Physiological / physiology
Blood Flow Velocity / physiology
Cardiac Output / physiology*
Positive-Pressure Respiration / methods*
Posture / physiology*
Pulmonary Circulation / physiology*
Pulmonary Ventilation / physiology*
Tidal Volume / physiology*
Grant Support

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