Depression of cardiac output is a mechanism of shunt reduction in the therapy of acute respiratory failure.

Abstract:

:The relationship between changes in cardiac output and intrapulmonary shunt associated with mechanical ventilation was evaluated in 20 patients with the adult respiratory distress syndrome (ARDS). The distribution of ventilation-perfusion (VA/Q) ratios and the level of intrapulmonary shunt was determined by the multiple inert gas technique. Pulmonary blood flow was distributed predominantly to either effective gas-exchanging units or shunt units. Positive end-expiratory pressure (PEEP) or high tidal volume ventilation led to decreases in shunt and cardiac output without altering the overall pattern of VA/Q distributions. Changes in shunt and cardiac output were quantitatively and qualitatively silimar and a strong correlation was found between changes in shunt and cardiac output with both PEEP and high tidal volumes (r = 0.76). Cardiac output depression associated with tese modes of ventilation appears to be a mechanism of shunt reduction in ARDS. Interpretation of improvements in gas exchange in ARDS must take into account concomitant hemodynamic changes.

journal_name

Chest

journal_title

Chest

authors

Dantzker DR,Lynch JP,Weg JG

doi

10.1378/chest.77.5.636

subject

Has Abstract

pub_date

1980-05-01 00:00:00

pages

636-42

issue

5

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)34907-8

journal_volume

77

pub_type

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