Document Detail

A potential method of correcting intracavitary left ventricular filling pressures for the effects of positive end-expiratory airway pressure.
MedLine Citation:
PMID:  4017218     Owner:  NLM     Status:  MEDLINE    
Based on the observation that positive end-expiratory airway pressure (PEEP) causes comparable increments in intrapericardial and right-sided intracardiac pressures, we hypothesized that intracavitary left ventricular filling pressures measured in the presence of PEEP can be corrected for increased intrathoracic pressure by subtracting the effects of PEEP on intracavitary right ventricular filling pressures. Ventricular function curves (aortic blood flow vs intracavitary left ventricular end-diastolic pressure [LVEDP]) were generated with and without 15 cm of water of PEEP in eight dogs. All curves were shifted to the right by PEEP (i.e., intracavitary LVEDP was higher for any submaximal level of aortic blood flow). However, when pressures measured in the presence of PEEP were "corrected" by subtracting the corresponding increment in intracavitary right ventricular end-diastolic pressure caused by PEEP at each level of ventricular filling, control and corrected PEEP data points appeared to fall on the same curve in five dogs, and differed only slightly in three dogs. Mean control and corrected PEEP curves derived by averaging polynomial regression coefficients for each condition differed significantly from uncorrected PEEP curves (p less than .05), but not from each other. Analogous curves based on mean left atrial pressure were corrected equally well by subtracting the effects of PEEP on mean right atrial pressure. We conclude that the increments in intracavitary right heart filling pressures caused by PEEP can be used to correct intracavitary left heart filling pressures for the effects of PEEP on intrathoracic pressure.
R V Ditchey; J Lindenfeld; E W Grogan; G O Zerbe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  72     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1985 Sep 
Date Detail:
Created Date:  1985-09-26     Completed Date:  1985-09-26     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  660-7     Citation Subset:  AIM; IM    
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MeSH Terms
Atrial Function
Forced Expiratory Flow Rates*
Peak Expiratory Flow Rate*
Ventricular Function*

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

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