Cardiovascular effects of positive-pressure ventilation in normal subjects

Cassidy, S. S.; Eschenbacher, William L.; Robertson, C. H.; Nixon, J.V.; Blomqvist, G.; Johnson, Robert L.

doi:10.1152/jappl.1979.47.2.453

Cited by 90 publications

(20 citation statements)

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“…Others have noted an increase in the amount of lung water with PEEP under certain specific experimental conditions (1,6,15). Our findings regarding rebreathing measurements of VTPC in piglets in this study as well as in dogs in a previous study from our laboratory (12) does differ from the study by Cassidy et al (3), who reported an increase in rebreathing VTPC in humans with the application of 10 cm H 2 0 PEEP. We cannot explain the difference between these studies.…”

Section: Discussioncontrasting

confidence: 92%

Measurement of Cardiopulmonary Function by Rebreathing Methodology in Piglets

1984

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Section: Discussioncontrasting

confidence: 92%

Measurement of Cardiopulmonary Function by Rebreathing Methodology in Piglets

1984

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“…PEEP generally decreases cardiac output, and the cause of this decrease has been the focus of much research over the past decade. A few studies in intact animals or humans have suggested impairment of cardiac contractility on PEEP [48,50]. MANNY et al [51] perfused an isolated heart with blood from a support dog.…”

Section: Steady-state Effects Positive End-expiratory Pressure and Comentioning

confidence: 99%

Heart-lung interactions: applications in the critically ill

Fessler¹

1997

Eur Respir J

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Since the circulatory and pulmonary systems are both driven by pressure and share space in the thorax, it is inevitable that they interact. These mechanical interactions, whilst relatively few in number, are protean in their manifestations.The circulatory system of the critically ill is often particularly susceptible to interference from respiration. Compensatory reserve is limited, ventilatory effort increased, and many critical care respiratory interventions place strain on the circulation, not seen in health.This review will examine the basic physiological mechanisms through which the pulmonary and circulatory systems interact. These mechanisms will then be applied to a variety of weaning, positive end-expiratory pressure (PEEP), and cardiopulmonary resuscitation techniques. It is hoped that this will provide the tools to understand clinical observations which would otherwise appear inexplicable.

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“…This technique has already been shown to be accurate and reproducible in animal studies of lung injury (6) and in adult human studies (7). Recently, we have shown that this technique provides an accurate measurement of cardiopulmonary function in mechanically ventilated piglets, comparable in size to the human neonate, including piglets with oleic-acid induced lung injury ventilated using PEEP (8).…”

mentioning

confidence: 93%

Measurement of Cardiopulmonary Function in Ventilated Neonates with Respiratory Distress Syndrome Using Rebreathing Methodology

et al. 1986

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ABSTRACT. The feasibility of using a multiple gas rebreathing technique to evaluate cardiopulmonary function in the ventilated neonate was assessed by measuring functional residual capacity, diffusing capacity of lung for carbon monoxide, and effective pulmonary capillary blood flow in 10 neonates with respiratory distress syndrome. Measurements were first made on the level of positive end expiratory pressure (PEEP) selected by the clinicians caring for the infants ("clinical" PEEP, mean of 4.4 2 0.3 cm H20). To evaluate the effect of P E E P on cardiopulmonary function, P E E P was then changed above (mean of 6.7 f 0.4 cm H 2 0 ) and below (mean of 1.9 + 0.3 cm H 2 0 ) this level and measurements were repeated. Mean functional residual capacity on clinical P E E P (10.8 + 1.6 ml/kg) was far below the predicted normal and varied directly with changes in P E E P (mean change of 1.2 ml/kg/cm H20). Diffusing capacity of the lung for carbon monoxide on clinical P E E P was 0.04 + 0.01 ml/min/mm Hg/kg and did not change significantly with changes in PEEP. Mean effective pulmonary capillary blood flow was highest (70 ml/min/kg) a t the lowest level of PEEP. However, the effect of increasing P E E P on effective pulmonary capillary blood flow in individual infants varied. Increasing P E E P increased arterial oxygen tension but did not cause changes in systemic arterial pressure or heart rate. We conclude that infants with respiratory distress syndrome have severe lung injury with decreased functional residual capacity and diffusing capacity of the lung for carbon monoxide, and that lung volume improves with the use of PEEP. Although P E E P has a beneficial effect on arterial oxygenation, it may impair systemic oxygen transport in some infants because of its detrimental effect on cardiac output. This detrimental effect on cardiac output could not be detected by usual clinical monitoring techniques. (Pediatr Res 20: 316-320,1986) Abbreviations HDS, respiratory distress syndrome PEEP, positive end expiratory pressure FRC, functional residual capacity QCm, effective pulmonary capillary blood flow DI,CO, diffusing capacity of the lung for carbon monoxide TcP02, transcutaneous oxygen tension PAo, mean systemic arterial blood pressure

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Cardiovascular effects of positive-pressure ventilation in normal subjects

Cited by 90 publications

References 0 publications

Measurement of Cardiopulmonary Function by Rebreathing Methodology in Piglets

Measurement of Cardiopulmonary Function by Rebreathing Methodology in Piglets

Heart-lung interactions: applications in the critically ill

Measurement of Cardiopulmonary Function in Ventilated Neonates with Respiratory Distress Syndrome Using Rebreathing Methodology

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