JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by DOWNS, J. B. Articles by HODGES, M. R. Search for Related Content PubMed PubMed Citation Articles by DOWNS, J. B. Articles by HODGES, M. R.

Ventilatory Pattern, Interpleural Pressure, and Cardiac Output

JOHN B. DOWNS, MD^*, MICHAL E. DOUGLAS, MAJOR, USAF (MC), PETER M. SANFELIPPO, LT COL, USAF (MC), WILLIAM STANFORD, COLONEL, USAF (MC), and MICHAEL R. HODGES^||

* Assistant Professor of Anesthesiology and Surgery, University of Florida College of Medicine, Box J-254, J. Hillis Miller Health Center, Gainesville, Florida 32610; Veterans Administration Hospital. Chief, Recovery Room/Surgical Intensive Care Service, Wilford Hall USAF Medical Center, Lackland AFB, Texas. Chief Resident, Cardiothoracic Surgical Section, Wilford Hall USAF Medical Center. Chief, Department of Surgery, Wilford Hall USAF Medical Center. ||Research Technician, Department of Anesthesiology, University of Utah College of Medicine, Salt Lake City, Utah.

Abstract

Continuous positive-pressure ventilation may decrease cardiac output. However, few reports have separated the effects of positive 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 < 0.001). Atrial filling pressures and cardiac output were unaffected by PEEP but decreased during IPPV (p < 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.

This article has been cited by other articles:

				A. R. FRANZ, C. MACK, J. REICHART, F. POHLANDT, and H. D. HUMMLER Preserved Spontaneous Breathing Improves Cardiac Output during Partial Liquid Ventilation Am. J. Respir. Crit. Care Med., July 1, 2001; 164(1): 36 - 42. [Abstract] [Full Text] [PDF]

				C. PUTENSEN, S. ZECH, H. WRIGGE, J. ZINSERLING, F. STUBER, T. VON SPIEGEL, and N. MUTZ Long-Term Effects of Spontaneous Breathing During Ventilatory Support in Patients with Acute Lung Injury Am. J. Respir. Crit. Care Med., July 1, 2001; 164(1): 43 - 49. [Abstract] [Full Text] [PDF]

				C. PUTENSEN, N. J. MUTZ, G. PUTENSEN-HIMMER, and J. ZINSERLING Spontaneous Breathing During Ventilatory Support Improves Ventilation-Perfusion Distributions in Patients with Acute Respiratory Distress Syndrome Am. J. Respir. Crit. Care Med., April 1, 1999; 159(4): 1241 - 1248. [Abstract] [Full Text] [PDF]

				M. E. Douglas, J. B. Downs, E. L. Mantini, and B. C. Ruiz Alteration of Oxygen Tension and Oxyhemoglobin Saturation: A Hazard of Sodium Bicarbonate Administration Arch Surg, March 1, 1979; 114(3): 326 - 329. [Abstract] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999