Key result
Mechanical ventilation with 10 cm H2O PEEP following open-heart surgery significantly decreased cardiac index, with responses varying based on pre-existing pulmonary vascular disease.
Why the study?
Does mechanical ventilation with PEEP alter hemodynamic performance and blood-gas exchange differently in patients with and without pre-existing pulmonary vascular disease following open-heart surgery?
Population
10 patients following open-heart surgery, including 5 following aortic valve replacement without pulmonary…
Comparison
Mechanical ventilation at constant tidal volume… vs Mechanical ventilation without PEEP.
Design
Cohort
Follow-up
1 hour after removal of PEEP
Authors
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May warrant individualized PEEP titration by pulmonary vascular status after open-heart surgery; hypothesis-generating and should not yet change practice.
Does mechanical ventilation with PEEP alter hemodynamic performance and blood-gas exchange differently in patients with and without pre-existing pulmonary vascular disease following open-heart surgery?
The hemodynamic and gas exchange responses to PEEP following open-heart surgery depend significantly on the presence of pre-existing pulmonary vascular disease and ventricular competence.
Trichet et al. (1975) studied Open-heart surgery (n=10). Mechanical ventilation with PEEP vs. Mechanical ventilation without PEEP was evaluated on Hemodynamic performance and blood-gas exchange (arterial Po2, alveolar-arterial Po2 gradient, Qs/Qt, cardiac index, Vd/Vt). Mechanical ventilation with 10 cm H2O PEEP following open-heart surgery significantly decreased cardiac index, with responses varying based on pre-existing pulmonary vascular disease.
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