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
Chestjournal_title
Chestauthors
Dantzker DR,Lynch JP,Weg JGdoi
10.1378/chest.77.5.636subject
Has Abstractpub_date
1980-05-01 00:00:00pages
636-42issue
5eissn
0012-3692issn
1931-3543pii
S0012-3692(16)34907-8journal_volume
77pub_type
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