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Positive end-expiratory pressure increases intraocular pressure in cats
U R Nimmagadda1, N J Joseph, M R Salem
1Department of Anesthesiology, Illinois Masonic Medical Center, Chicago 60657.
Background And Methods:
The purpose of the present study was to examine the effect of various levels of positive end-expiratory pressure on intraocular pressure in cats. Fourteen healthy adult cats (2.6 to 3.7 kg) without evidence of ocular disease were anesthetized with pentobarbital, paralyzed, and placed on mechanical ventilation. Direct continuous measurements of heart rate (HR), mean arterial pressure (MAP), CVP, CSF pressure, and intraocular pressure were recorded at zero end-expiratory pressure, and at 5, 10, and 15 cm H2O positive end-expiratory pressure, applied in random order.
Main Results:
There were no significant changes in pHa, Paco2, HR, MAP, hematocrit, and temperature. Intraocular pressure increased significantly from 17 (during zero end-expiratory pressure) to 20 mm Hg at 10 cm H2O positive end-expiratory pressure; at 15 cm H2O positive end-expiratory pressure, intraocular pressure increased significantly to 21 mm Hg. CVP and CSF pressure increased significantly in parallel with intraocular pressure at 5, 10, and 15 cm H2O positive end-expiratory pressure.
Conclusions:
We speculate that similar responses occur in man, and may be undesirable in patients with already increased intraocular pressure, when higher levels of positive end-expiratory pressure are used.