Document Detail

Ventilatory pattern, intrapleural pressure, and cardiac output.
MedLine Citation:
PMID:  319705     Owner:  NLM     Status:  MEDLINE    
Continuous positive-pressure ventilation may decrease cardiac output. However, a few reports have separated the effects of positive and end-expiratory pressure (PEEP) from those of mechanical ventilation. Ten surgical patients requiring mechanical ventilatory support had catheters inserted for measurement of right atrial pressure (RAP), pulmonary artery occlusion pressure (PAOP), intrapleural, radial artery, airway, and atrial filling pressures, and cardiac output. All patients breathed spontaneously between mechanical breaths delivered every 30 seconds by intermittent mandatory ventilation (IMV). Measurements were made with 0, 5, and 10 cm H2O PEEP, and during intermittent positive-pressure ventilation (IPPV) with 12 breaths/min without PEEP. Airway pressure (Paw), intrapleural pressure, RAP, and PAOP were increased by PEEP and IPPV. Intrapleural pressure increased most during IPPV (p less than 0.001). Atrial filling pressures and cardiac output were unaffected by PEEP but decreased during IPPV (p less than 0.001). Patients receiving IMV maintained negative intrapleural pressure, atrial filling pressure, cardiac output and, therefore, O2 delivery, regardless of PEEP level. The authors conclude that patients requiring mechanical respiratory support, with or without PEEP, may maintain better cardiopulmonary function when allowed some spontaneous ventilatory activity.
J B Downs; M E Douglas; P M Sanfelippo; W Stanford; M R Hodges
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  56     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:    1977 Jan-Feb
Date Detail:
Created Date:  1977-03-31     Completed Date:  1977-03-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  88-96     Citation Subset:  IM    
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MeSH Terms
Blood Gas Analysis
Blood Pressure
Cardiac Output*
Intermittent Positive-Pressure Breathing
Pleura / physiology*
Positive-Pressure Respiration
Respiration, Artificial*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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