• Zhongguo Wei Zhong Bing Ji Jiu Yi Xue · Jun 2006

    [Clinical study of the setting of positive end expiratory pressure in patients with acute cardiogenic pulmonary edema during mechanical ventilation].

    • Wei Zhang, Ling Huang, Yin-zhi Qin, Na-xin Zhang, and Shu-peng Wang.
    • Department of Intensive Care Unit, Tianjin Third Central Hospital, Tianjin 300170, China.
    • Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2006 Jun 1;18(6):367-9.

    ObjectiveTo compare the effects on hemodynamics and lung mechanics when different positive end expiratory pressure (PEEP) levels were used in acute cardiac pulmonary edema.MethodsThirty-nine patients with respiratory failure and treated with mechanical ventilation were divided into two groups according to cardiac index (CI). The changes of hemodynamics [including cardiac output (CO), CI, pulmonary capillary blood flow (PCBF), central venous pressure (CVP), surround vascular resistance (SVR)], lung mechanical variables [intrinsic positive end expiratory pressure (PEEPi), peak inspiratory pressure (Ppeak), mean of airway pressure (Pmean), minute volume (MV), alveolar tidal volume (Vtalv)], percutaneous saturation of oxygen (SpO(2)) and blood pressure (BP) were determined with when selected different PEEP levels under the bi-level positive airway pressure (BIPAP) mode in normal cardiac function group (n=18, CI> or =2.0 L.min(-1).m(-2)) and poor cardiac function group (n=20, CI<2.0 L.min(-1)xm(-2)).ResultsIn normal cardiac function group, PEEP has no effect on hemodynamics when varied from 0-13 cm H(2)O (1 cm H(2)O=0.098 kPa), and Ppeak and PEEPi increased with the elevation of PEEP. Resistance of airway (R) fell when PEEP was increased. However, in poor cardiac function group SVR, CO, CI showed curvilinear changes with an increase in PEEP, and CO, CI were high when PEEP changed from 0 to 7 cm H(2)O, but dropped markedly when PEEP was increased in 13 cm H(2)O, while the changes of SVR was the reverse of CO and CI. The effects on lung mechanics varied relatively smaller range when PEEP was set between 5-7 cm H(2)O, and the burden of breathing was slight.ConclusionThe mode of artificial ventilation should be adjusted according to the changes in hemodynamics and lung mechanics. PEEP should be individualized, and 5-7 cm H(2)O (normally below 10 cm H(2)O) is suitable.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…