Effects of extrinsic positive end-expiratory pressure on cardiopulmonary function in patients with chronic obstructive pulmonary disease.

Abstract:

OBJECTIVE:To choose one optimal extrinsic positive end-expiratory pressure (PEEPe) for ventilated patients with chronic obstructive pulmonary disease (COPD) and to compare two methods for choosing the optimal level of PEEPe. METHODS:Ten ventilated patients with COPD were included in the study. First, static intrinsic positive end-expiratory pressure (PEEPi, st) was measured when PEEPe was zero, and the PEEPi, st was called PEEPi, stz. PEEPe at 0%, 40%, 50%, 60%, 70%, 80%, 90% and 100% of PEEPi, stz, respectively, were applied randomly. Respiratory mechanics, hemodynamics, and oxygen dynamics were recorded 30 minutes after the level of PEEPe was changed. RESULTS:When PEEPe was not higher than 80% of PEEPi, stz, no measurement changed significantly. When PEEPe was increased to 90% and 100% of PEEPi, stz, PEEPi, st, peak inspiratory pressure, plateau pressure, pulmonary capillary wedge pressure and central venous pressure increased significantly, P < 0.01. Cardiac output and left ventricular work index decreased significantly, P < 0.01. Oxygen delivery decreased significantly, P < 0.05. When PEEPe was increased to 100% of PEEPi, stz, the right ventricular work index decreased significantly, P < 0.05. CONCLUSION:Eighty percent of PEEPi, stz was the upper limit of PEEPe. The results of the two methods used to set the level of PEEPe were identical.

journal_name

Chin Med J (Engl)

journal_title

Chinese medical journal

authors

Kong W,Wang C,Yang Y,Huang K,Jiang C

keywords:

subject

Has Abstract

pub_date

2001-09-01 00:00:00

pages

912-5

issue

9

eissn

0366-6999

issn

2542-5641

journal_volume

114

pub_type

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