Korean J Anesthesiol.  1982 Mar;15(1):1-12.

Experimental Study on Ventilatory and Cardiopulmonary Effect by Positive End-Expiratory Pressure Ventilation in Acute Respiratory Distress Syndrome

• Kim KW

Abstract

Changes of oxygen transport, oxygen consumption and hemodynamic variables in the cardiopulmonary system were studied before and after induction of acute respiratory distress syndrome(ARDS) in anesthetized dogs. Ejection fractions(EF) from both ventricies were measured by intravenous injection of 99m Tc-DTPA through Swan-Ganz Catheters. The following results were obtained: 1) Experimental dogs were intratracheally sprayed with 0.1NHCl(2ml/kg), which definitely induced ARDS in dogs. 2) Oxygen uptake and ventilatory activities were not improved in normal dogs by 10cm H2P of PEEP(positive end expiratory pressure). ARDS induced dogs improved in oxygen uptake(p<0.05), but not in ventilatory activity by 10cm H2O of PEEP. 3) By applying 10cm H2O of PEEP, normal dogs showed decreased effects in oxygen transport and oxygen consumption(p<0.01), ARDS induces dogs have increased oxygen transport and oxygen comsumption(p<0.05). These effects showed no change by 10cm H2O of PEEP in ARDS induced dogs. 4) Normal dogs and ARDS induced dogs have significantly decreased effects in cardiac output and blood pressure by 10cm H2O of PEEP(p<0.01). 5) Normal dogs and ARDs induced dogs showed significantly increased effects in central venous pressure, mean pulmonary artery pressure, pulmonary capiliary wedge pressure, systemic vascular resistance and pulmonary vascular resistance by 10cm H2O of PEEP(p<0.05). 6) Ejection fractions(EF) were decreased in both ventricles in normal dogs and ARDS induced dogs by 10cm H2O of PEEP particularly a definite decrease in EF of the right ventricle(p<0.005). All the above observations clearly demonstrated that mechanisms of decrease in cardiac output by PEEP are closedly related to decreased effects in EF of both ventricles, particularly definite decrease in EF of the right ventricle.

MeSH Terms

Animals
Blood Pressure
Cardiac Output
Catheters
Central Venous Pressure
Dogs
Heart Ventricles
Hemodynamics
Injections, Intravenous
Oxygen
Oxygen Consumption
Positive-Pressure Respiration*
Pulmonary Artery
Pulmonary Wedge Pressure
Respiratory Distress Syndrome, Adult*
Technetium Tc 99m Pentetate
Vascular Resistance
Ventilation*
Oxygen
Technetium Tc 99m Pentetate