The effects of airway pressure on cardiac function in intact dogs and man.

Published

Journal Article

Ventilation with positive end-expiratory pressure (PEEP) is associated with reduced cardiac output, but the mechanisms involved are controversial. Possible explanations include increased intrathoracic pressure, reflex changes in myocardial inotropism, pulmonary vascular obstruction and abnormal ventricular interaction. Three types of conscious canine preparations were developed to examine simultaneously each of these factors during ventilation with PEEP. In addition, similar measurements were obtained in patients after cardiac surgical procedures and compared with the results of animal experiments. The primary cause of reduced cardiac output during PEEP appeared to be a diminished end-diastolic volume of the left ventricle, and this appeared to be the result of elevated intrathoracic pressure and increased impedance to blood flow through the lungs. Abnormal interventricular septal shifting and reflex autonomic alterations did not appear to be significant in the normal cardiovascular system. These data provide insight into the cardiac effects of PEEP and emphasize the importance of simultaneous quantification of biventricular performance when assessing cardiopulmonary function.

Full Text

Duke Authors

Cited Authors

  • Rankin, JS; Olsen, CO; Arentzen, CE; Tyson, GS; Maier, G; Smith, PK; Hammon, JW; Davis, JW; McHale, PA; Anderson, RW; Sabiston, DC

Published Date

  • July 1982

Published In

Volume / Issue

  • 66 / 1

Start / End Page

  • 108 - 120

PubMed ID

  • 7044610

Pubmed Central ID

  • 7044610

International Standard Serial Number (ISSN)

  • 0009-7322

Digital Object Identifier (DOI)

  • 10.1161/01.cir.66.1.108

Language

  • eng

Conference Location

  • United States