Skip to main content
SpringerLink
Log in

Der Einfluß von PEEP auf die Hämodynamik und Organdurchblutung

  • Chapter
Akute respiratorische Insuffizienz

  • 22 Accesses

Zusammenfassung

Die Beatmung mit positiv-end-exspiratorischem Druck (PEEP) zur symptomatischen Behandlung bei akuter respiratorischer Insuffizienz (ARJ) ist seit etwa 20 Jahren ein anerkanntes, erfolgreiches Behandlungsprinzip [3]. Die günstige Beeinflussung der pathologischen Lungenfunktion bei der ARJ durch PEEP ist klinisch eindeutig und durch zahlreiche Untersuchungen belegt [2, 3, 6, 8, 23, 37,42]:

  1. a)

    Normalisierung der eingeschränkten funktionellen Residualkapazität

  2. b)

    Verbesserung der verminderten Compliance der Lunge

  3. c)

    Ausgleich der Ventilations-Perfusions-Mißverhältnisse

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Aidinis SJ, Lafferty J, Shapiro HM (1976) Intracranial responses to PEEP. Anesthesiology 45: 275

    Article  PubMed  CAS  Google Scholar 

  2. Ashbaugh DG, Petty TL (1973) Positive end-expiratory pressure: Physiology, indications and contraindications. J Thorac Cardiovasc Surg 65: 165

    PubMed  CAS  Google Scholar 

  3. Ashbaugh DG, Petty TL, Bigelow DB, Harris TM (1969) Continuous positive-pressure breathing ( CPPB) in adult respiratory distress syndrome. J Thorac Cardiovasc Surg 57: 31

    PubMed  CAS  Google Scholar 

  4. Cassidy SS, Robertson CH, Pierce AK, Johnson RL (1978) Cardiovascular effects of positive end-expiratory pressure in dogs. J Appl Physiole: Respirat Environ Exercise Physiol 44: 743

    CAS  Google Scholar 

  5. Cournand A, Motley HL, Werko L, Richards DW (1948) Physiological studies of the effects of intermittent positive pressure breathing on cardiac output in man. Am J Physiol 152: 162

    PubMed  CAS  Google Scholar 

  6. Downs JB, Klein EF, Modell JH (1953) The effect of incremental PEEP on Pa02 in patients with respiratory failure. Anesth Anaig (Cleve) 52: 210

    Google Scholar 

  7. Elkins RC, Peyton MD, Hinshaw LB, Greenfield LJ (1974) Clinical hemodynamic and respiratory responses to graded positive end-expiratory pressure. Surg Forum 25: 206

    Google Scholar 

  8. Falke KJ, Pontoppidan H, Kumar A, Leith DE, Geffin B, Laver MB (1972) Ventilation with end-expiratory pressure in acute lung disease. J Clin Invest 51: 2315

    Article  PubMed  CAS  Google Scholar 

  9. Fermoso JD, Richardson TR, Guyton AC (1964) Mechanism of decrease in cardiac output caused by opening the chest. Am J Physiol 207: 1112

    PubMed  CAS  Google Scholar 

  10. Gabriele G, Rosenfeld CR, Fixier DE, Wheeler JM (1977) Continuous airway pressure breathing with the head-box in the newborn lamb: effects on regional blood flows. Pediatrics 59: 858

    PubMed  CAS  Google Scholar 

  11. Gammanpila S, Beran DR, Bhudu R (1977) Effect of positive and negative expiratory pressure on renal function. Brit J Anesth 49: 199

    Article  CAS  Google Scholar 

  12. Giordano J, Harken A (1975) Effect of continuous positive pressure ventilation on cardiac output. Am Surg 41: 221

    PubMed  CAS  Google Scholar 

  13. Guyton AC, Jones CE, Coleman TG (1973) Mean circulatory pressure, mean systemic pressure, and mean pulmonary pressure and their effect on venous return. In Circulatory Physiology: Cardiac output and its regulation. Saunders Chap 12, p. 205

    Google Scholar 

  14. Hall SV, Johnson EE, Hedley-Whyte J (1974) Renal hemodynamics and function with continuous positive pressure ventilation in dogs. Anesthesiology 41: 452

    Article  PubMed  CAS  Google Scholar 

  15. Harken AH, Brennan MF, Smith B (1974) The hemodynamic response to positive end-expiratory ventilation in hypovolemic patients. Surgery 76: 786

    PubMed  CAS  Google Scholar 

  16. Hedley-Whyte JG, Burgers GE, Feeley TW, Miller MG (1976) Applied Physiology of Respiratory Care. Little Brown, Boston

    Google Scholar 

  17. Hobelmann CF, Smith DE, Virgilio RW, Shapiro AR, Peters RM (1975) Hemodynamic alteration with positive end-expiratory pressure: The contribution of the pulmonary vasculature. J Trauma 15: 951

    Article  PubMed  Google Scholar 

  18. Horster M, Thurau K (1968) Micropuncture studies on the filtration rate of single superficial and iuxtamedullary glomeruli in the rat kidney. Pflügers Archiv, Physiol Menschen Tiere 301: 162

    Article  CAS  Google Scholar 

  19. Hugget ASG (1924) Studies on the respiration and circulation of the cat. IV. The heart output during respiratory obstruction. J Physiol 59: 373

    Google Scholar 

  20. Johnson EE (1975) Splanchnic hemodynamic response to passive hyperventilation. J Appl Physiol 38: 156

    PubMed  CAS  Google Scholar 

  21. Johnson EE, Hedley-Whyte J (1972) Continuous positive-pressure ventilation and portal flow in dogs with pulmonary edema. J Appl Physiol 33: 385

    PubMed  CAS  Google Scholar 

  22. Kirby RR, Perry JC, Calderwood HW, Ruiz BC, Ledermann DS (1975) Cardiorespiratory effects of high positive end-expiratory pressure. Anesthesiology 43: 533

    Article  PubMed  CAS  Google Scholar 

  23. Kumar A, Falke KJ, Geffin B, Aldredge CF, Laver MB, Lowenstein E, Pontoppidan H (1970) Continuous positive-pressure ventilation in acute respiratory failure: effects on hemodynamics and lung function. N Engl j Med 283: 1430

    Article  PubMed  CAS  Google Scholar 

  24. Kumar A, Pontoppidan H, Baratz RA, Laver MB (1974) Inappropriate response to increased plasma ADH during mechanical ventilation in acute respiratory failure. Anesthesiology 40: 215

    Article  PubMed  CAS  Google Scholar 

  25. Laver MB (1979) Right and left ventricular function in critically ill patients. Post-Graduate course “Intensive care of the critically ill”. Havard Medical School and Massachusetts General Hospital

    Google Scholar 

  26. Manny J, Justice RE, Hechtmann H (1978) Maldistribution of blood flow during positive end-expiratory pressure. Surgical Forum 29: 205

    Google Scholar 

  27. Manny J, Patten MT, Liebmann PR, Hechtmann HB (1978) The association of lung distension, PEEP and biventricular failure. Ann Surg 18: 151

    Article  Google Scholar 

  28. Menkes HA, Traystman RJ, Bromberger-Barnea B (1974) Interdepence of the chambers of the heart during ventilation with positive end-expiratory pressure (abstr.). Circulation 50 (suppl III): 22

    Google Scholar 

  29. Moore ES, Galvez MB, Paton JB, Fisher DE, Behrmann RE (1974) Effects of positive pressure ventilation on intrarenal blood flow in infant primates. Pediat Res 8: 792

    PubMed  CAS  Google Scholar 

  30. Lenfant C, Howell BJ (1960) Cardiovascular adjustments in dogs during continuous positive pressure breathing. J Appl Physiol 15: 425

    PubMed  CAS  Google Scholar 

  31. Liebmann PR, Patten MT, Manny J, Shepro D, Hechtmann HB (1978) The mechanism of depressed cardiac output on positive end-expiratory pressure. Surgery 83: 594

    Google Scholar 

  32. Lopez-Muniz R, Stephens NL, Bromberger-Barnea B, Permutt S, Riley R (1968) Critical closure of pulmonary vessels analyzed in terms of Starling resistor modell. J Appl Physiol 24: 625

    PubMed  CAS  Google Scholar 

  33. Permutt S, Bromberger-Barnea B, Bane HN (1962) Alveolar pressure, pulmonary venous pressure and vascular waterfall. Med Thorac 19: 239

    PubMed  CAS  Google Scholar 

  34. Permutt S, Howell JEL, Proctor DF, Riley RL (1961) Effect of lung inflation static pressure-volume characteristics of pulmonary vessels. J Appl Physiol 16: 64

    PubMed  CAS  Google Scholar 

  35. Pichlmayr J, Mascher E, Sippel R (1974) Untersuchungen zur Wirkung unterschiedlicher Beatmungs-formen und arterielle Blutgaswerte, periphere Kreislaufgrößen und die Gehirndurchblutung. Anaesthesist 23: 535

    PubMed  CAS  Google Scholar 

  36. Pontoppidan H, Wilson R, Rie MA, Schneider RC (1977) Respiratory intensive care. Anesthesiology 47: 96

    Article  PubMed  CAS  Google Scholar 

  37. Powers SR (1974) The use of positive end-expiratory pressure for respiratory support. Surg Clin Amer 54: 1125

    Google Scholar 

  38. Powers SR, Mannal R, Neclerio M, English M, Marr C, Leather R, Ueda H, Williams G, Custead W, Dutton R (1973) Physiologie consequences of positive end-expiratory pressure ( PEEP) ventilation. Ann Surg 178: 265

    Article  PubMed  Google Scholar 

  39. Qvist J, Pontoppidan H, Wilson RS, Lowenstein E, Laver MB et al: Hemodynamic responses to mechanical ventilation with PEEP: The effect of hypovolemia. Anesthesiology 42: 45

    Google Scholar 

  40. Shapiro HN (1975) Intracranial hypertension. Therapeutic and anesthetic considerations. Anesthesiology 43: 443

    Google Scholar 

  41. Sykes MK, Adams AP, Finlay WE, Mc Cormick PW, Economides A (1970) The effects of variations in end-expiratory inflation pressure on cardiorespiratory function in normo-, hypo- and hypervolemic dogs. Brit J Anesth 42: 669

    Article  CAS  Google Scholar 

  42. Suter PM, Fairley HB, Isenberg MD (1975) Optimum end-expiratory airway pressure in patients with acute pulmonary failure. N Engl J Med 292: 284

    Article  PubMed  CAS  Google Scholar 

  43. Trichet B, Falke K, Togut A, Laver MB (1975) The effect of pre-existing pulmonary vascular disease on the response to mechanical ventilation with PEEP following open-heart surgery. Anesthesiology 42: 56

    Article  PubMed  CAS  Google Scholar 

  44. Tucker HJ, Murray JF (1973) Effects of end-expiratory pressure on organ blood flow in normal and diseased dogs. J Appl Physiol 34: 573

    PubMed  CAS  Google Scholar 

  45. West JB (1969) Effects of interstitial pressure. In Fishman AP, Hecht HH (eds.): The pulmonary circulation and interstitial space. University of Chicago press p 43

    Google Scholar 

  46. West JB, Dollery CT, Heard BE (1965) Increased pulmonary resistence in the dependent zone of the isolated dog lung caused by perivascular edema. Circ Res 17: 191

    PubMed  Google Scholar 

  47. Wildsmith JAW, Marshall RL (1978) Positive end-expiratory pressure. Immediate hemodynamic effects during artifical ventilation. Anaesthesia 33: 20

    Article  PubMed  CAS  Google Scholar 

  48. Wolff G, Grädel E (1954) Hemodynamic performance and weaning form mechanical ventilation following open-heart surgery. Europ J Intens Care Med 1: 99

    Article  Google Scholar 

  49. Zapol WM, Snider MT (1977) Pulmonary hypertension in severe acute respiratory failure. N Engl J Med 296: 476

    Article  PubMed  CAS  Google Scholar 

  50. Zarins CK, Virgilio RW, Smith DE, Peters RM (1977) Effect of vascular volume on PEEP induced cardiac output depression and wedge left atrial pressure discrepancy, J Surg Res 23: 348

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. U. Jensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Peter
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Institut für Anaesthesiologie, Universität München, Klinikum Großhadern, Marchioninistr. 15, 8000, München 70, Germany

    Klaus Peter

  2. Institut für Anästhesiologie, Ludwig-Maximilians-Universität München, D-8000, München, Germany

    Klaus Peter

Rights and permissions

Reprints and permissions

Copyright information

© 1980 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Jensen, U., Peter, K. (1980). Der Einfluß von PEEP auf die Hämodynamik und Organdurchblutung. In: Peter, K. (eds) Akute respiratorische Insuffizienz. Anaesthesiologie und Intensivmedizin Anaesthesiology and Intensive Care Medicine, vol 131. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-67723-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-67723-6_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-10185-7

  • Online ISBN: 978-3-642-67723-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation