Echocardiographic analysis of cardiac function during high PEEP ventilation
J E Berglund1, E Haldén, S Jakobson
1Department of Anaesthesiology and Intensive Care, University Hospital, Uppsala, Sweden.
Objective:
Does positive end-expiratory pressure ventilation (PEEP) deteriorate cardiac contractility?
Design:
By means of echocardiography nine piglets were studies during ventilation with 0, 15 and 25 cmH2O (PEEP). Recordings were made before and after 500 ml of 6% dextran 70.
Measurement And Results:
Right and left ventricular end-diastolic diameters were plotted against the stroke volume determined by the thermodilution technique. By combining observations made before and after volume expansion during the different ventilation modes, a ventricular function curve was obtained. The slopes of the curves were similar during all three ventilation modes, both on the left and on the right side.
Conclusion:
This study indicates undisturbed myocardial contractility during PEEP ventilation. We infer that the cardiac output deterioration in the intact animal is caused entirely by impairment of venous return.
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