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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.
Intensive Care Medicine
|January 1, 1994
Summary
Positive end-expiratory pressure ventilation (PEEP) does not impair cardiac contractility. Cardiac output changes during PEEP are due to reduced venous return, not weakened heart muscle function.
Area of Science:
- Cardiology
- Pulmonology
- Critical Care Medicine
Background:
- Positive end-expiratory pressure (PEEP) is a mechanical ventilation strategy used to improve oxygenation.
- The impact of PEEP on cardiac contractility remains a subject of investigation, particularly in intact animal models.
Purpose of the Study:
- To investigate whether positive end-expiratory pressure (PEEP) ventilation deteriorates myocardial contractility.
- To differentiate the effects of PEEP on cardiac contractility versus venous return.
Main Methods:
- Echocardiography was used to assess cardiac function in nine piglets under varying levels of PEEP (0, 15, and 25 cmH2O).
- Ventricular function curves were generated by plotting end-diastolic diameters against stroke volume, measured via thermodilution, before and after volume expansion.
Main Results:
- The slopes of the left and right ventricular function curves remained similar across all tested PEEP levels.
- No significant deterioration in myocardial contractility was observed during PEEP ventilation.
Conclusions:
- Myocardial contractility is preserved during positive end-expiratory pressure (PEEP) ventilation.
- Cardiac output reduction associated with PEEP in intact animals is primarily attributable to impaired venous return, not diminished cardiac contractility.