The Effects of Variations in End-Expiratory Inflation Pressure on Cardiorespiratory Function in Normo-, Hypo and Hypervolaemic Dogs

Sykes, M.K.; Adams, A.P.; Finlay, W.E.I.; McCormick, Patrick W.; Economides, Apollo P.

doi:10.1093/bja/42.8.669

Cited by 71 publications

(10 citation statements)

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“…Positive-pressure ventilation significantly lowers cardiac output in both spontaneous circulation and during CPR. 57,[62][63][64][65] Use of lower tidal volumes during prolonged cardiac arrest was not associated with significant differences in Pao 2 66 and is currently recommended. 67 Additionally, positive-pressure ventilation in an unprotected airway may cause gastric insufflation and aspiration of gastric contents.…”

Section: Minimal Chest Rise: Optimal Ventilation Pressure and Volumementioning

confidence: 99%

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Meaney¹,

Bobrow²,

Mancini³

et al. 2013

Circulation

864

521

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The "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" increased the focus on methods to ensure that high-quality cardiopulmonary resuscitation (CPR) is performed in all resuscitation attempts. There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation. Although it is clear that high-quality CPR is the primary component in influencing survival from cardiac arrest, there is considerable variation in monitoring, implementation, and quality improvement. As such, CPR quality varies widely between systems and locations. Victims often do not receive high-quality CPR because of provider ambiguity in prioritization of resuscitative efforts during an arrest. This ambiguity also impedes the development of optimal systems of care to increase survival from cardiac arrest. This consensus statement addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance; monitoring, feedback, and integration of the patient’s response to CPR; team-level logistics to ensure performance of high-quality CPR; and continuous quality improvement on provider, team, and systems levels. Clear definitions of metrics and methods to consistently deliver and improve the quality of CPR will narrow the gap between resuscitation science and the victims, both in and out of the hospital, and lay the foundation for further improvements in the future.

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Section: Minimal Chest Rise: Optimal Ventilation Pressure and Volumementioning

confidence: 99%

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Meaney¹,

Bobrow²,

Mancini³

et al. 2013

Circulation

864

521

View full text Add to dashboard Cite

show abstract

“…A stereotyped hemodynamic response to application of PEEP cannot be expected since both the relationship between available blood volume and capacity of the intravascular bed (12) as well as the type of underlying lung disease (13) PEEP may produce regional changes in lung volume with redistribution of blood flow to ventilated-perfused and ventilated, nonperfused parts of the lung (17,18). Third, an alteration of pulmonary mechanics may lead to improved gas distribution.…”

Section: Discussionmentioning

confidence: 99%

Ventilation with end-expiratory pressure in acute lung disease

Falke¹,

Pontoppidan²,

Kumar³

et al. 1972

J. Clin. Invest.

375

104

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“…This was expected due to the volume expansion performed at the beginning of the study (loading dose of inulin). When intra-thoracic pressure increases rapidly, central blood volume decreases (13). Therefore, in the present study, variations in cardiac output and in the regional distribution of blood might have occurred during the inspiratory phase, especially in the V T 27 group.…”

Section: Discussionmentioning

confidence: 58%

Glomerular filtration is reduced by high tidal volume ventilation in an in vivo healthy rat model

Luque

Shimizu

Andrade

et al. 2009

Braz J Med Biol Res

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Mechanical ventilation has been associated with organ failure in patients with acute respiratory distress syndrome. The present study examines the effects of tidal volume (V T) on renal function using two V T values (8 and 27 mL/kg) in anesthetized, paralyzed and mechanically ventilated male Wistar rats. Animals were randomized into two groups of 6 rats each: V T8 (V T, 8 mL/kg; 61.50 ± 0.92 breaths/min; positive end-expiratory pressure, 3.0 cmH2O; peak airway pressure (PAW), 11.8 ± 2.0 cmH2O), and V T27 (V T, 27 mL/kg; 33.60 ± 1.56 breaths/min; positive end-expiratory pressure, none, and PAW, 22.7 ± 4.0 cmH2O). Throughout the experiment, mean PAW remained comparable between the two groups (6.33 ± 0.21 vs 6.50 ± 0.22 cmH2O). For rats in the V T27 group, inulin clearance (mL·min-1·body weight-1) decreased acutely after 60 min of mechanical ventilation and even more significantly after 90 min, compared with baseline values (0.60 ± 0.05 and 0.45 ± 0.05 vs 0.95 ± 0.07; P < 0.001), although there were no differences between groups in mean arterial pressure or gasometric variables. In the V T8 group, inulin clearance at 120 min of mechanical ventilation remained unchanged in relation to baseline values (0.72 ± 0.03 vs 0.80 ± 0.05). The V T8 and V T27 groups did not differ in terms of serum thiobarbituric acid reactive substances (3.97 ± 0.27 vs 4.02 ± 0.45 nmol/mL) or endothelial nitric oxide synthase expression (94.25 ± 2.75 vs 96.25 ± 2.39%). Our results show that glomerular filtration is acutely affected by high tidal volume ventilation but do not provide information about the mechanism

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The Effects of Variations in End-Expiratory Inflation Pressure on Cardiorespiratory Function in Normo-, Hypo and Hypervolaemic Dogs

Cited by 71 publications

References 0 publications

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Cardiopulmonary Resuscitation Quality: Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital

Ventilation with end-expiratory pressure in acute lung disease

Glomerular filtration is reduced by high tidal volume ventilation in an in vivo healthy rat model

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