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Monitoring During PEEP Ventilation in Patients with Severe Left Ventricular Failure Using Transesophageal Echocardiography

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Transesophageal Echocardiography

Abstract

Mechanical ventilation with positive end-expiratory pressure (PEEP) considerably reduces cardiac output [1–6]. This has been attributed to reduction of venous return and transmural right and left ventricular (LV) pressure [1, 2, 7, 8], but unchanged or even increased transmural right or LV pressure has also been found [8–11]. A reduction in myocardial contractility and ventricular interdependence has been discussed [9, 12, 13].

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References

  1. Ashbaugh DG, Petty TL (1973) Positive end-expiratory pressure. J Thorac Cardiovasc Surg 65:165–170.

    PubMed  CAS  Google Scholar 

  2. Cournand A, Motley HL, Werko L, Richards DW (1948) Physiological studies of the effects of the intermittent positive pressure breathing on cardiac output in man. Am J Physiol 152:162–173.

    PubMed  CAS  Google Scholar 

  3. Kirby RR, Downs JB, Civetta JM et al. (1975) High level positive end-expiratory pressure (PEEP) in acute respiratory insufficiency. Chest 67:156–163.

    Article  PubMed  CAS  Google Scholar 

  4. Kumar A, Falke KJ, Geffin B et al. (1970) Continuous positive-pressure ventilation in acute respiratory failure. N Engl J Med 283:1430–1436.

    Article  PubMed  CAS  Google Scholar 

  5. Tucker HJ, Murray JF (1972) Effects of end-expiratory pressure on organ blood flow in normal and diseased dogs. J App. Physiol 34:573–577.

    Google Scholar 

  6. Walkinshaw M, Shoemaker WC (1980) Use of volume loading to obtain preferred levels of PEEP: preliminary study. Crit Care Med 8:81–86.

    Article  PubMed  CAS  Google Scholar 

  7. Qvist J, Pontoppidan H, Wilson RS, Lowenstein E, Laver MB (1975) Hemodynamic responses to mechanical ventilation with PEEP. The effect of hypervolemia. Anaes-thesiology 42:45–55.

    CAS  Google Scholar 

  8. Simonneau G, Lemaire F, Harf A, Teisseire C, Teisseire B (1982) A comparative study of the cardiorespiratory effects of continuous positive airway pressure breathing and continuous positive pressure ventilation in acute respiratory failure. Intensive Care Med 8:61–67.

    Article  PubMed  CAS  Google Scholar 

  9. Cassidy SS, Robertson CH, Pierce AK, Johnson RL (1978) Cardiovascular effects of positive end-expiratory pressure in dogs. J Appl Physiol 44:743–750.

    PubMed  CAS  Google Scholar 

  10. Dhainaut JF, Bricard C, Monsallier FJ et al. (1982) Left ventricular contractility using isovolumic phase indices during PEEP in ARDS patients. Crit Care Med 10:631–635.

    Article  PubMed  CAS  Google Scholar 

  11. Scharf SM, Caldini P, Ingram HR (1977) Cardiovascular effects of increasing airway pressure in the dog. Am J Physiol 232:H35–H43.

    PubMed  CAS  Google Scholar 

  12. Manny JM, Patten MT, Liebman PR, Hechtmann HB (1978) The association of lung distenion, PEEP and biventricular failure. Ann Surg 187:151–157.

    Article  PubMed  CAS  Google Scholar 

  13. Laver MB, Strauss HW, Pohost GM (1979) Right and left ventricular geometry: adjustments during acute respiratory failure. Crit Care Med 7:509–519.

    Article  PubMed  CAS  Google Scholar 

  14. Matsumoto M, Oka Y, Strom J et al. (1980) Application of transesophageal echocardiography to continuous intraoperative monitoring of left ventricular performance. Am J Cardiol 46:05.

    Google Scholar 

  15. Schlüter M, Hanrath P (1984) The clinical application of transesophageal echocardiography. Echocardiography 1:427.

    Article  Google Scholar 

  16. Beaupré PN, Kremer P, Cahalan MK, Lurz FW, Schiller B, Hamilton WK (1984) Intraoperative detection of changes in left ventricular sequential wall mition by transesophageal two-dimentional echocardiography. Am Heart J 107:1021.

    Article  PubMed  Google Scholar 

  17. Smith JS, Benefiel DJ, Lurz Wet al. (1984) Detection of intraoperative myocardial ischemia: ECG vs. 2-D transesophageal echocardiography (abstr). Anesthesiology 61:A158.

    Google Scholar 

  18. Cronelly R, Kremer PF, Baupré PN, Cahalan MK, Salvatierra O, Feduska N (1983) Hemodynamic response to anesthesia in patients with end-state renal disease. Anesthesiology59:A47.

    Google Scholar 

  19. Beaupré P, Cahalan M, Kremer P, et al. (1983) Contractility depression during anesthesia: compaison of haolthane, enflurane and isoflurane by transesophageal echocardiography (abstr). Circulation [Suppl] 11:332.

    Google Scholar 

  20. Page EB (1963) Ordered hypotheses for multiple treatments: a significance test for linear ranks. J Am Statist Assoc 58:216–230.

    Article  Google Scholar 

  21. Holm S (1979) A simple sequentially rejective multiple test procedure. Scand J Statist 6:65–70.

    Google Scholar 

  22. Matsumoto M, Osa Y, Strom J et al. (1980) Application of transesophageal echocardiography to continuous intraoperative monitoring of left ventricular performance. Am J Cardiol 46:95–105.

    Article  PubMed  CAS  Google Scholar 

  23. Matsumoto M, Hanrath P, Kremer P et al. (1982) Evaluation of left ventricular performance during supine exercise by transesophageal M-mode echocardiography in normal subjects. Br Heart J48:61–66.

    Article  PubMed  CAS  Google Scholar 

  24. Toma Y, Matsuda Y, Matsuzaki M et al. (1983) Determination of atrial size by esophageal echocardiography. Am J Cardiol 52:878–880.

    Article  PubMed  CAS  Google Scholar 

  25. Terai C, Uenishi M, Sugimoto H, Shimazu T, Yoshioharu T, Sugimoto T (1985) Transesophageal echocardiographic dimensional analysis of four cardiac chambers during positive end-expiratory pressure. Anaesthesiology 63:640–646.

    Article  CAS  Google Scholar 

  26. Barach AL, Echman M, Ginsberg E (1946) Positive pressure respiration studies on general aspects and types of pressure breathing. J Aviat Med 17:290.

    PubMed  CAS  Google Scholar 

  27. Lutch JS, Murray JF (1972) Continuous positive-pressure ventilation: effects on systemic oxygen transport and tissue oxygenation. Ann Int Med 76:193–202.

    PubMed  CAS  Google Scholar 

  28. Powers SR, Mannal R, Neclerio M et al. (1973) Physiologic consequences of positive end-expiratory pressure (PEEP) ventilation. Ann Surg 178:265–272.

    Article  PubMed  Google Scholar 

  29. Braunwald E, Binion JT, Morgan WL et al. (1957) Alterations in central blood volume and cardiac output induced by positive pressure breathing and counteracted by metaraminol (Aramine). Circ Res 5:670–675.

    PubMed  CAS  Google Scholar 

  30. Morgan BC, Crawford EW, Guntheroth WG (1969) The hemodynamic effects of changes in blood volume during intermittent positive-pressure ventilation. Anaesthesiology 30:297–305.

    Article  CAS  Google Scholar 

  31. Sykes MK, Adams AP, Finley WEI et al. (1970) The effect of variations in end-expiratory inflation pressure on cardiorespiratory function in normo-, hypo-and hyper-volemic dogs. Br J Anaesth 42:669–677.

    Article  PubMed  CAS  Google Scholar 

  32. Niskimura N, Obayashi K, Takano T (1980) Hemodynamic effect of positive end-expiratory pressure (PEEP) in severe heart failure due to acute myocardial infarction (AMI). Crit Care Med8:229.

    Article  Google Scholar 

  33. Fewell JE, Abendschein DR, Carlson CJ, Rapaport E, Murray JF (1981) Continuous positive pressure ventilation does not alter ventricular pressure volume relationship. Am J Physiol240:H821–H826.

    PubMed  CAS  Google Scholar 

  34. Fewell JF, Abendschein DR, Carlson CJ, Murray JF, Rapaport E (1980) Continuous positive pressure ventilation decreases right and left ventricular end-diastolic volumes in dog. Cir Res46:125–132.

    CAS  Google Scholar 

  35. Dhainaut JF, Devaux JY, Schlemmer B et al. (1983) Effects of PEEP on right ventricular function in ARDS patients (abstr). Intensive Care Med 9:149.

    Google Scholar 

  36. Viquerat CE, Righetti A, Suter PM (1983) Biventricular volumes and function in patients with adult respiratory distress syndrome ventilated with PEEP. Chest 3:509–514.

    Article  Google Scholar 

  37. Koolen JJ, Visser CA, Wever E, van Wezel H, Meyne NG, Dunning AJ (1987) Transesophageal two-dimensional echocardiographic evaluation of biventricualr dimension and function during positive end-expiratory ventilation after coronary artery bypass grafting. Am J Cardiol 59:1047–1051.

    Article  PubMed  CAS  Google Scholar 

  38. Jardin F, Farcot J, Bosiante L, Curien N, Margiaraz A, Bourdarias JP (1981) Influences of positive end-expiratory pressure on left ventricular performance. N Engl J Med 304:387–392.

    Article  PubMed  CAS  Google Scholar 

  39. Robotham JL, Bell RC, Badke FR, Kindred MK (1985) Left ventricular geometry during positive end-expiratory pressure in dogs. Crit Care Med 13:617–624.

    Article  PubMed  CAS  Google Scholar 

  40. Forrester JS, Diamond G, Chatterjee K, Swan JC (1976) Medical therapy of acute myocardial infarction by application of hemodynamic subsets. N Engl J Med 295:1404–1412.

    Article  PubMed  CAS  Google Scholar 

  41. Skarvan K, Hasse J, Wolf G (1981A) Myocardial transmural pressure in ventilated patients. Intensive Care Med 7:277–283.

    Article  PubMed  CAS  Google Scholar 

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© 1989 Springer-Verlag Berlin Heidelberg

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Schuster, S., Erbel, R., Weilemann, L.S., Lu, W., Wellek, S. (1989). Monitoring During PEEP Ventilation in Patients with Severe Left Ventricular Failure Using Transesophageal Echocardiography. In: Erbel, R., Khandheria, B.K., Brennecke, R., Meyer, J., Seward, J.B., Tajik, A.J. (eds) Transesophageal Echocardiography. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-74257-6_24

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  • DOI: https://doi.org/10.1007/978-3-642-74257-6_24

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-74259-0

  • Online ISBN: 978-3-642-74257-6

  • eBook Packages: Springer Book Archive

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