Assessment of cardiac filling pressure during continuous positive pressure ventilation

Critical Care Medicine
J B Downs, M E Douglas

Abstract

Before and after 10 dogs were near-drowned with fresh water, cardiac filling pressures were measured during spontaneous respiration, controlled mechanical ventilation with ambient expiratory airway pressure, continuous positive-pressure ventilation (CPPV) with 20 ml H2O PEEP, and CPPV alone. Pulmonary arterial occlusion and left ventricular end diastolic pressures were measured and compared. Intrapleural pressure was subtracted from values for each of these pressures to calculate respective transmural filling pressures. Mechanical ventilation and CPPV each decreased thoracic venous return, but only CPPV increased pulmonary arteriolar resistance. The increase of both airway pressure and pulmonary arteriolar resistance, in turn, increased both right atrial and pulmonary arterial occlusion pressures, but decreased left ventricular filling. Thus, measurement of pulmonary arterial occlusion pressure alone did not allow accurate assessment of cardiac filling pressure. The authors found that measurement of intrapleural pressure was necessary to obtain an accurate reflection of left ventricular filling pressure during CPPV. Momentary interruption of CPPV to measure any pressure was of no value in assessing vascular filling and caused p...Continue Reading

Citations

Nov 1, 1982·Current Problems in Surgery·J V Snyder, G C Carroll
Sep 1, 1986·Progress in Cardiovascular Diseases·R B McGrath
Dec 1, 1992·Journal of Cardiothoracic and Vascular Anesthesia·B A ShapiroW T Peruzzi
Feb 22, 2005·European Journal of Anaesthesiology·M DavidB Eberle
Feb 1, 1988·Anaesthesia and Intensive Care·W B RuncimanA J Rutten
Apr 1, 1989·DICP : the Annals of Pharmacotherapy·M W PerkinsB DeHaven

Related Concepts

Metazoa
Blood Circulation
Cardiac Output
Canis familiaris
Use-Effectiveness
Heart
Positive End-Expiratory Pressure

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Lipidomics & Rhinovirus Infection

Lipidomics can be used to examine the lipid species involved with pathogenic conditions, such as viral associated inflammation. Discovered the latest research on Lipidomics & Rhinovirus Infection.

Alzheimer's Disease: MS4A

Variants within the membrane-spanning 4-domains subfamily A (MS4A) gene cluster have recently been implicated in Alzheimer's disease in genome-wide association studies. Here is the latest research on Alzheimer's disease and MS4A.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Torsion Dystonia

Torsion dystonia is a movement disorder characterized by loss of control of voluntary movements appearing as sustained muscle contractions and/or abnormal postures. Here is the latest research.

Generating Insulin-Secreting Cells

Reprogramming cells or using induced pluripotent stem cells to generate insulin-secreting cells has significant therapeutic implications for diabetics. Here is the latest research on generation of insulin-secreting cells.

Central Pontine Myelinolysis

Central Pontine Myelinolysis is a neurologic disorder caused most frequently by rapid correction of hyponatremia and is characterized by demyelination that affects the central portion of the base of the pons. Here is the latest research on this disease.

Epigenome Editing

Epigenome editing is the directed modification of epigenetic marks on chromatin at specified loci. This tool has many applications in research as well as in the clinic. Find the latest research on epigenome editing here.