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J Appl Physiol 69: 2190-2196, 1990;
8750-7587/90 $5.00
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Journal of Applied Physiology, Vol 69, Issue 6 2190-2196, Copyright © 1990 by American Physiological Society

ARTICLES

Effects of PEEP on pulmonary hemodynamics in intact dogs with oleic acid pulmonary edema

M. Leeman, P. Lejeune, J. Closset, J. L. Vachiery, C. Melot and R. Naeije
Laboratory of Cardiovascular and Respiratory Physiology, Erasme University Hospital, Brussels, Belgium.

The effects of positive end-expiratory pressure (PEEP) on the pulmonary circulation were studied in 14 intact anesthetized dogs with oleic acid (OA) lung injury. Transmural (tm) mean pulmonary arterial pressure (Ppa)/cardiac index (Q) plots with transmural left atrial pressure (Pla) kept constant were constructed in seven dogs, and Ppa(tm)/PEEP plots with Q and Pla(tm) kept constant were constructed in seven other dogs. Q was manipulated by using a femoral arteriovenous bypass and a balloon catheter inserted in the inferior vena cava. Pla was manipulated using a balloon catheter placed by thoracotomy in the left atrium. Ppa(tm)/Q plots were essentially linear. Before OA, the linearly extrapolated pressure intercept of the Ppa(tm)/Q relationship approximated Pla(tm). OA (0.09 ml/kg into the right atrium) produced a parallel shift of the Ppa(tm)/Q relationship to higher pressures; i.e., the extrapolated pressure intercept increased while the slope was not modified. After OA, 4 Torr PEEP (5.4 cmH2O) had no effect on the Ppa(tm)/Q relationship and 10 Torr PEEP (13.6 cmH2O) produced a slight, not significant, upward shift of this relationship. Changing PEEP from 0 to 12 Torr (16.3 cmH2O) at constant Q before OA led to an almost linear increase of Ppa(tm) from 14 +/- 1 to 19 +/- 1 mmHg. After OA, Ppa(tm) increased at 0 Torr PEEP but changing PEEP from 0 to 12 Torr did not significantly affect Ppa(tm), which increased from 19 +/- 1 to 20 +/- 1 mmHg. These data suggest that moderate levels of PEEP minimally aggravate the pulmonary hypertension secondary to OA lung injury.


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 Am. J. Respir. Crit. Care Med.Home page
A. PAGNAMENTA, Y. BOUCKAERT, P. WAUTHY, S. BRIMIOULLE, and R. NAEIJE
Continuous versus Pulsatile Pulmonary Hemodynamics in Canine Oleic Acid Lung Injury
Am. J. Respir. Crit. Care Med., September 1, 2000; 162(3): 936 - 940.
[Abstract] [Full Text]


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