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Related Experiment Videos

Lung water increases with fluid administration during CPPV after pulmonary microembolization.

W H Noble, J C Kay

    Anesthesiology
    |December 1, 1984
    PubMed
    Summary
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    Continuous positive-pressure ventilation improves oxygenation but reduces cardiac output. Volume infusion with dextran can restore cardiac output and improve tissue oxygenation, but may worsen pulmonary edema in high pulmonary vascular resistance settings.

    Area of Science:

    • Cardiovascular Physiology
    • Respiratory Physiology
    • Critical Care Medicine

    Background:

    • Pulmonary microemboli cause hypoxemia, often treated with continuous positive-pressure ventilation (CPPV).
    • CPPV improves oxygenation but reduces cardiac output (Q) and increases pulmonary vascular resistance (PVR), potentially leading to pulmonary edema.
    • Strategies to maintain Q during CPPV in high PVR settings are crucial for tissue oxygenation.

    Purpose of the Study:

    • To investigate the effects of volume infusion (dextran 40) on cardiac output and tissue oxygenation in dogs with pulmonary microemboli-induced high PVR during CPPV.
    • To assess the impact of restoring cardiac output on tissue oxygenation indices and pulmonary edema.

    Main Methods:

    • Induction of pulmonary microemboli in 14 dogs to create high PVR.

    Related Experiment Videos

  • Application of CPPV (15 cm H2O) and monitoring of PaO2 and Q.
  • Infusion of dextran 40 in a 'volume group' to restore pre-CPPV Q, while a 'control group' was monitored without infusion.
  • Measurement of lung water, O2 transport, PVO2, O2 consumption, and metabolic acidosis over 3 hours.

    • Main Results:

    • CPPV increased PaO2 but decreased Q significantly.
    • Volume infusion with dextran 40 successfully restored Q to pre-CPPV levels.
    • Restoration of Q improved tissue oxygenation indices, including O2 transport, PVO2, O2 consumption, and reduced metabolic acidosis.
    • Volume infusion significantly increased lung water, doubling the amount compared to the control group by 3 hours.

    Conclusions:

    • Volume infusion can counteract the reduction in cardiac output caused by CPPV in the setting of high PVR.
    • Improved cardiac output enhances tissue oxygenation and reduces metabolic acidosis.
    • However, volume infusion exacerbates pulmonary edema in this model, highlighting a critical trade-off.