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[Left ventricular function. Study during artificial ventilation with PEEP in the dog (author's transl)]

A Net, G Vazquez, S Benito

    Anesthesie, Analgesie, Reanimation
    |January 1, 1981
    PubMed
    Summary

    Positive end-expiratory pressure (PEEP) did not induce left ventricular failure in healthy dogs. Ventricular function remained stable or improved with increasing PEEP levels, challenging previous hypotheses.

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    Area of Science:

    • Cardiovascular Physiology
    • Respiratory Mechanics
    • Anesthesiology

    Context:

    • Artificial ventilation in patients often involves positive end-expiratory pressure (PEEP).
    • Previous hypotheses suggested PEEP could cause intramyocardial vessel collapse, leading to myocardial ischemia and left ventricular failure.
    • Understanding PEEP's direct effects on ventricular function is crucial for patient management.

    Purpose:

    • To investigate the direct impact of increasing positive end-expiratory pressure (PEEP) levels on left ventricular function.
    • To test the hypothesis that PEEP-induced intramyocardial vessel collapse leads to left ventricular failure.

    Summary:

    • Left ventricular end-diastolic pressure (LVEDP) and ventricular function were measured in normal dogs subjected to escalating PEEP (up to 40 cm H2O).

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  • Results indicated that the Starling relationship remained unaltered and within a hypercontractility pattern.
  • Ventricular function stayed on the same curve up to 30 cm H2O PEEP, then shifted to a higher contractility curve at 40 cm H2O PEEP.

    • Impact:

    • The study suggests that, under the tested experimental conditions, left ventricular failure due to PEEP is unlikely in healthy subjects.
    • These findings challenge the assumption of PEEP-induced myocardial ischemia causing ventricular dysfunction.
    • Provides evidence supporting the safety of PEEP in maintaining cardiac function in certain clinical scenarios.