Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Zobel, G; Dacar, D; Rödl, S.
Hemodynamic effects of different modes of mechanical ventilation in acute cardiac and pulmonary failure: an experimental study.
CRIT CARE MED 1994 22: 1624-1630.
Doi: 10.1097/00003246-199422100-00019
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Zobel Gerfried
- Co-Autor*innen der Med Uni Graz
- Dacar Drago
- Roedl Siegfried
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- Abstract:
- OBJECTIVE: To determine the hemodynamic effects of four different modes of mechanical ventilation in an animal model of acute cardiac and pulmonary failure. DESIGN: Prospective, randomized, crossover design. SETTING: University research laboratory. SUBJECTS: Twelve piglets weighing 10 to 16 kg. INTERVENTIONS: The experimental protocol consisted of three stable 30-min periods: when ventricular and pulmonary functions were normal (control), after the induction of acute cardiac failure by the administration of a beta-adrenergic receptor blocker, and after pulmonary failure induced by repeated lung lavage. Modes of mechanical ventilation included controlled mechanical ventilation, high-frequency oscillation, synchronized high-frequency jet ventilation, and external negative pressure oscillation combined with pressure support ventilation. Each mode of respiratory support was randomly and sequentially applied to each animal with the assessment of cardiopulmonary function at the end of each period. MEASUREMENTS AND MAIN RESULTS: Continuous monitoring included electrocardiogram, right atrial, left ventricular end-diastolic, pulmonary arterial, intrathoracic aortic, arterial, esophageal, and transpulmonary pressures and arterial and mixed venous oxygen saturation measurements. In addition, cardiac output using the thermodilution technique was measured intermittently. Whereas in the control period cardiac index was significantly (p < .05) higher during synchronized high-frequency jet ventilation (193 +/- 19.3 mL/kg/min) than during controlled mechanical ventilation (151 +/- 12.1 mL/kg/min) and high-frequency oscillation (151 +/- 18.1 mL/kg/min), there was no significant hemodynamic difference between the four modes of mechanical ventilation in the cardiac and pulmonary failure periods. In the pulmonary failure period, transpulmonary pressure was significantly higher during high-frequency oscillation (7.1 +/- 1.6 mm Hg) than during controlled mechanical ventilation (5.6 +/- 0.6 mm Hg), high-frequency ventilation (4.1 +/- 0.4 mm Hg), and external negative pressure oscillation combined with pressure support ventilation (5.3 +/- 0.5 mm Hg). CONCLUSIONS: Synchronized high-frequency ventilation improves cardiac performance in control conditions. No hemodynamic difference is present between the four modes of mechanical ventilation in the cardiac and pulmonary failure periods. External negative pressure oscillation combined with pressure support ventilation has moderate hemodynamic advantages over controlled mechanical ventilation and high-frequency oscillation in different clinical settings, but it also results in a deterioration of pulmonary gas exchange during the pulmonary failure period.
- Find related publications in this database (using NLM MeSH Indexing)
- Animals -
- Comparative Study -
- Cross-Over Studies -
- Disease Models, Animal -
- Female -
- Heart Arrest - therapy
- Hemodynamic Processes - therapy
- High-Frequency Jet Ventilation - therapy
- High-Frequency Ventilation - therapy
- Male - therapy
- Prospective Studies - therapy
- Research Support, Non-U.S. Gov't - therapy
- Respiration, Artificial - methods
- Respiratory Insufficiency - therapy
- Swine - therapy
- Find related publications in this database (Keywords)
- Mechanical Ventilation
- High-Frequency Jet Ventilation
- High-Frequency Oscillation
- Hemodynamics
- Cardiac Failure
- Respiratory Failure
- Critical Illness
- Cardiopulmonary Emergencies