Document Detail

The effect of increasing end-expiratory pressure on extravascular lung water.
MedLine Citation:
PMID:  7022725     Owner:  NLM     Status:  MEDLINE    
The objective of this study was to define the response of extravascular lung water (EVLW) to different levels of positive end-expiratory pressure (PEEP) following a standardized oleic acid injury to the lung. All animals responded to the injection of intravenous oleic acid by the rapid development of hypoxemia. There was a twofold increase in EVLW during the first 3 hours after oleic acid injection which remained stable during the remainder of the experiment, including periods on PEEP. Intrapulmonary shunt (Qs/Qt) increased significantly (P less than 0.001) during the first hour following oleic acid injection. PEEP therapy resulted in an immediate decrease in Qs/Qt and amelioration of the hypoxemia. Return to zero PEEP resulted in a rapid decrease in PaO2 with concomitant increase in Qs/Qt by the end of the experiment. The oxygen transport in the animals did not improve significantly with the addition of PEEP. This was due to the decrease in cardiac output that more than offset the effects of a diminished Qs/Qt with PEEP. This study indicates that the mechanism by which PEEP improves oxygenation does not appear to be mediated by effect on lung water. The study also emphasizes the importance of determining oxygen transport when managing patients on PEEP.
A B Peitzman; W A Corbett; G T Shires; N J Lynch; G T Shires
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Surgery     Volume:  90     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1981 Sep 
Date Detail:
Created Date:  1981-10-25     Completed Date:  1981-10-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  439-45     Citation Subset:  AIM; IM    
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MeSH Terms
Anoxia / chemically induced
Cardiac Output
Lung / drug effects
Oleic Acids
Oxygen / blood,  physiology
Positive-Pressure Respiration*
Pulmonary Edema / chemically induced,  physiopathology,  therapy*
Ventilation-Perfusion Ratio
Grant Support
Reg. No./Substance:
0/Oleic Acids; 7782-44-7/Oxygen

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

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