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Mitral Stenosis I: Introduction01:22

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...

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Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit
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Open lung ventilation does not increase right ventricular outflow impedance: An echo-Doppler study.

Dinis Reis Miranda1, Lennart Klompe, Joris Mekel

  • 1Department of Anesthesiology, Erasmus MC, Rotterdam, The Netherlands.

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Open Lung Concept (OLC) ventilation with high PEEP did not increase right ventricular outflow impedance during expiration. OLC ventilation decreased impedance during inspiration in cardiac surgery patients.

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Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Critical Care Medicine

Background:

  • Elevated positive end-expiratory pressure (PEEP) in Open Lung Concept (OLC) ventilation may increase right ventricular afterload.
  • Investigating OLC's impact on right ventricular outflow impedance is crucial for cardiac surgery patients.

Purpose of the Study:

  • To evaluate the effect of OLC ventilation on right ventricular outflow impedance during inspiration and expiration.
  • To compare OLC ventilation with conventional ventilation in post-cardiac surgery patients.

Main Methods:

  • Prospective, randomized, controlled clinical study in a cardiothoracic intensive care unit.
  • Twenty-eight post-cardiac surgery patients underwent both OLC and conventional ventilation.
  • Transesophageal echo-Doppler assessed right ventricular outflow impedance.

Main Results:

  • OLC ventilation used higher PEEP (14 cm H2O) than conventional ventilation (5 cm H2O).
  • Right ventricular outflow impedance during expiration was similar between OLC and conventional ventilation.
  • OLC ventilation decreased right ventricular outflow impedance during inspiration compared to expiration.

Conclusions:

  • OLC ventilation, despite elevated PEEP, does not increase right ventricular outflow impedance during expiration.
  • OLC ventilation reduces right ventricular outflow impedance during inspiration.
  • OLC ventilation may be safe for right ventricular function in post-cardiac surgery patients.