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Continuous Positive Airway Pressure During Mechanical and Spontaneous Ventilation Effects on Central Haemodynamics and Oxygen Transport
Author(s) -
Vuori A.,
Jalonen J.,
Laaksonen V.
Publication year - 1979
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1979.tb01474.x
Subject(s) - medicine , pulmonary wedge pressure , oxygen transport , hemodynamics , anesthesia , cardiac output , cardiac index , mechanical ventilation , central venous pressure , vascular resistance , continuous positive airway pressure , oxygen tension , ventilation (architecture) , oxygen , arterial blood , blood pressure , cardiology , heart rate , mechanical engineering , chemistry , organic chemistry , obstructive sleep apnea , engineering
The effect of continuous positive airway pressure during continuous mechanical (CMV + PEEP) and spontaneous (CPAP) ventilation on central haemodynamics and systemic oxygen transport was studied in 10 male patients who had undergone aortocoronary bypass graft operation 18 h earlier. With the change from CMV + PEEP 5 cmH 2 O to CPAP 5 cmH 2 O, cardiac index was found to increase from 2.58 + 0.44 (s.e. mean) to 2.88 2 0.19 1/min/m 2 ( P< 0.005), and systemic oxygen transport improved from 8.5 ± 0.6 to 9.5±1.0 ml/min/kg (P<0.05). Arterial oxygen tension and content did not change, but mixed venous blood oxygen tension increased from 3.5 ± 0.2 to 4.2 ±0.2 kPa ( P< 0.005), reflecting the increase in cardiac output. Arteriovenous oxygen content difference decreased from 4.6±0.5 (CMV+PEEP) to 3.6±0.2 (CPAP) m1/100 ml ( P <0.05), while total oxygen consumption remained unchanged. Mean systemic arterial pressure was found to increase from 10.8 ± 0.4 to 11.6 ± 0.4 kPa ( P< 0.05) and mean pulmonary arterial pressure changed from 2.2 ±0.1 to 2.4 ±0.1 kPa (P<0.05). Right atrial and pulmonary capillary wedge pressures did not change. Our observations suggest that, in terms of central haemodynamics and tissue oxygen supply, CPAP offers a noteworthy alternative weaning method and an alternative to CMV+PEEP in cases where therapy is prolonged and the patient is able to breathe spontaneously.