ANESTHESIA A N D ANALGESIA . . . Current Researches Voi.. 56. No. I , .JAN.-FEB.. 1977

88

Ventilatory Pattern, Int ra p le u ra

I

and Cardiac Output

JOHN B. DOWNS, MD* MICHAL E. DOUGLAS, MAJOR, USAF (MC)? PETER M. SANFELIPPO, LT COL, USAF (MC)f

WILLIAM STANFORD, COLONEL, USAF (MC)S MICHAEL

R. HODGES~~

Continuous positive-pressure ventilation may decrease cardiac output. However, few reports have separated t h e effects of positive end-expiratory pressure (PEEP) f r o m those of mechanical ventilation. T e n surgical patients requiring mechanical v e n t i l a t o r y support had catheters inserted for measurement of r ig h t a tr i al pressure (RAI’), pulmonary a r te r y 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 H 2 0 PEEP, and d u r i n g i n t er m i t t en t p o s i t i v e - p r e s s u r e v e n t i l a t i o n

(IPI’V) with 12 breaths/min without PEEP. Airway pressure ( Paw ) , intrapleural pressure, RAP, and P A O P were increased by PEEP and II’PV- Intrapleural pressure increased most duri n g IPI’V ( p < O . O O l ) . Atrial filling pressures and cardiac output were unaffected by PEEP but decreased d u r i n g IPI’V (1~

Ventilatory pattern, intrapleural pressure, and cardiac output.

ANESTHESIA A N D ANALGESIA . . . Current Researches Voi.. 56. No. I , .JAN.-FEB.. 1977 88 Ventilatory Pattern, Int ra p le u ra I and Cardiac Outp...
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