| The effect of incremental positive end-expiratory pressure on right ventricular hemodynamics and ejection fraction. | |
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MedLine Citation:
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PMID: 3277479 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The effects of incremental positive end-expiratory pressure (PEEP) on right ventricular (RV) function were evaluated in 36 (n = 36) ventilated patients. Positive end-expiratory pressure was increased from 0 (baseline) to 20 cm H2O in 5-cm H2O increments and RV hemodynamics and thermally derived right ventricular ejection fraction (RVEF), right ventricular end-diastolic volume index (RVEDVI), and right ventricular end-systolic volume index (RVESVI) were computed. Right ventricular contractility was determined from the analysis of RV systolic pressure-volume relations. Right ventricular ejection fraction declined from 42 +/- 8% at baseline to 30 +/- 9% at 20 cm H2O PEEP. Right ventricular end-diastolic volume index declined between 0 and 5 cm H2O PEEP (103 +/- 42 to 92 +/- 34 ml.m-2) and then increased to 113 +/- 40 at 20 cm H2O PEEP. Right ventricular end-systolic volume index increased from 60 +/- 31 ml.m-2 at baseline to 79 +/- 34 ml.m-2 at 20 cm H2O PEEP. The slope (E) of the relation of RV peak systolic pressure to RV end-systolic volume index decreased from 0.26 mm Hg.m2.ml-1 between PEEP of 0-15 cm H2O to 0.05 mm Hg.m2.m-1 at PEEP greater than 15 cm H2O. It is concluded that low levels of PEEP have a predominant preload reducing effect on the RV. Above 15 cm H2O PEEP, RV volumes increase and E decreases, consistent with increased RV afterload and a decline in RV contractility. |
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Authors:
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J W Biondi; D S Schulman; R Soufer; R A Matthay; R L Hines; H R Kay; P G Barash |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 67 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 1988 Feb |
Date Detail:
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Created Date: 1988-03-07 Completed Date: 1988-03-07 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 144-51 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06510. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Anoxia / therapy Cardiac Output* Cardiac Volume* Female Humans Intermittent Positive-Pressure Ventilation* Male Middle Aged Myocardial Contraction Positive-Pressure Respiration* Postoperative Complications / therapy Stroke Volume* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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