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KMID : 0378019830260010112
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New Medical Journal
1983 Volume.26 No. 1 p.112 ~ p.124
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The Effect of Positive End-Expiratory Pressure Ventilation on Tissue Oxygen Utilization in Dogs with Acute Respirtoary Distress Syndrome
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Abstract
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In order to evaluate the effects of 10cm H2O PEEP on tissue oxygen utilization, 10 anesthetized dogs were studied before and after ARDS induced by acid aspiration with 0.1 N HCl, 2ml/kg.
Under F1O2 of 0.21, blood gas, hemoglobin, central venous pressure, pulmonary capillary wedge pressure, mean arterial pressure, cardiac output and arterial and mixed venous oxygen tension were measured in dogs ventilated with constant minute volume during control (IPPV only), 10cm H2O PEEP on control, ARDS and 10cm H2O PEEP on ARDS.
Using above data, systemic vascular resistance, pulmonary vascular resistance, arterial and mixed venous oxygen content, systemic oxygen transport, oxygen consumption and oxygen extraction ratio were calculated by standard formula and the following results were obtained.
1. Arterial and mixed venous oxygen tension, saturation and content were remained unaltered during 10cm H2O PEEP on control, but improved significantly during 10cm H20 PEEP on ARDS comparing with control and ARDS respectively.
2. Systemic oxygen transport and oxygen consumption decreased remarkably during 10cm H2O PEEP on control compared with normal dogs, but remained unaltered during 10cm H2O PEEP on ARDS compared with ARDS dogs.
3. Oxygen extraction ratio remained unaltered during 10cm H2O PEEP on control, but tended to increase during 10cm 1120 PEEP on ARDS.
4. During 10cm H2O PEEP on control and ARDS, cardiac output decreased significantly but systemic vascular resistance and pulmonary vascular resistance increased significantly.
The above findings suggest that after ARDS using 10cm H2O PEEP may exert a significant lowering effect on cardiac performance, but there was no adverse effects on tissue oxygenation, e.g., systemic oxygen transport, oxygen consumption and oxygen extraction ratio.
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KEYWORD
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