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Related Experiment Videos

Haemodynamic changes during positive-pressure ventilation in children.

A Kardos1, G Vereczkey, C Szentirmai

  • 1Paediatric Intensive Care Unit, Heim Pál Children's Hospital, Ullõi Str. 89, 1086 Budapest, Hungary. dr.kardos@axelero.hu

Acta Anaesthesiologica Scandinavica
|April 20, 2005
PubMed
Summary

Positive-pressure ventilation can affect cardiac function. This study found that increasing positive end-expiratory pressure (PEEP) did not significantly alter hemodynamics in children, but lowering PEEP improved stroke volume index and cardiac index.

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Area of Science:

  • Pediatric critical care medicine
  • Cardiopulmonary physiology
  • Mechanical ventilation

Background:

  • Positive-pressure ventilation (PPV) is a cornerstone of respiratory support in critically ill children.
  • PPV can influence cardiovascular dynamics, particularly in patients with compromised cardiac function.
  • Understanding these interactions is crucial for optimizing ventilator settings and patient outcomes.

Purpose of the Study:

  • To investigate the impact of varying positive end-expiratory pressure (PEEP) levels on central hemodynamics in mechanically ventilated children without pulmonary pathology.
  • To assess changes in cardiac output and tissue perfusion indicators using impedance cardiography (ICG) and central venous oxygen saturation (ScvO2).

Main Methods:

  • A prospective study involving 12 children (7-65 months) on mechanical ventilation for non-pulmonary conditions.

Related Experiment Videos

  • Impedance cardiography (ICG) and central venous saturation (ScvO2) were used to monitor hemodynamic parameters.
  • Positive-pressure ventilation with controlled airway pressure was applied, systematically increasing and then decreasing PEEP from 5 to 15 cmH2O.

    • Main Results:

    • Elevating PEEP to 10 and 15 cmH2O did not significantly alter cardiac index (CI).
    • Slight, non-significant reductions in stroke volume index (SVI) and ScvO2 were observed with increased PEEP.
    • Decreasing PEEP to 5 cmH2O resulted in statistically significant increases in SVI and CI.

    Conclusions:

    • PEEP titration within the studied range did not induce significant hemodynamic compromise in this pediatric population.
    • Lowering PEEP to 5 cmH2O was associated with improved ventricular performance (SVI) and cardiac output (CI).
    • ScvO2 remained stable, suggesting preserved tissue oxygen delivery despite hemodynamic fluctuations.