Accuracy of hemodynamic measurements during partial liquid ventilation with perflubron. 2000

H E Fessler, and D Pearse
Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. hfessler@welch.jhu.edu

Patients undergoing partial liquid ventilation (PLV) are often monitored with pulmonary artery catheters and receive positive end-expiratory pressure (PEEP). PEEP can dissociate wedge pressure (Pcw) from transmural left atrial pressure (Platm) by elevating pleural pressure and can dissociate Pcw from Pla by elevating alveolar pressure, PLV, like PEEP, also elevates pleural and alveolar pressures. However, the artifacts PLV may cause in measured vascular pressures are unknown. In 6 anesthetized, paralyzed healthy adult sheep, we compared effects of gas ventilation (GV) and PLV with 10 and 30 ml/kg perflubron on pericardial pressure (Pperi), Pcw, Pla, thermodilution cardiac output, and pulmonary artery flow measured with a doppler probe. PEEP was applied from 0-15 mm Hg during GV and PLV. PLV changed pericardial pressure or cardiac output minimally (at PEEP(0), GV: Pperi = -1.7 +/- 0.6 mm Hg, CO = 3. 2 +/- 0.1 L/m; 10 ml/kg perflubron: Pperi = -1.3 +/- 0.6 mm Hg, CO = 3.4 +/- 0.2 L/m; 30 ml/kg perflubron: Pperi = -1.6 +/- 0.7 mm Hg, CO = 3.4 +/- 0.2 L/m; all mean +/- SEM). On PEEP, Pcw agreed with Pla and Platm as well or better during PLV as during gas ventilation. Cardiac output by thermodilution and probe agreed equally well under all conditions. We conclude that hemodynamic values are as accurate during PLV as during gas ventilation.

UI MeSH Term Description Entries
D011175 Positive-Pressure Respiration A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange. Positive End-Expiratory Pressure,Positive-Pressure Ventilation,End-Expiratory Pressure, Positive,End-Expiratory Pressures, Positive,Positive End Expiratory Pressure,Positive End-Expiratory Pressures,Positive Pressure Respiration,Positive Pressure Ventilation,Positive-Pressure Respirations,Positive-Pressure Ventilations,Pressure, Positive End-Expiratory,Pressures, Positive End-Expiratory,Respiration, Positive-Pressure,Respirations, Positive-Pressure,Ventilation, Positive-Pressure,Ventilations, Positive-Pressure
D011669 Pulmonary Wedge Pressure The blood pressure as recorded after wedging a CATHETER in a small PULMONARY ARTERY; believed to reflect the PRESSURE in the pulmonary CAPILLARIES. Pulmonary Artery Wedge Pressure,Pulmonary Capillary Wedge Pressure,Pulmonary Venous Wedge Pressure,Wedge Pressure,Pressure, Pulmonary Wedge,Pressures, Pulmonary Wedge,Pulmonary Wedge Pressures,Wedge Pressure, Pulmonary,Wedge Pressures, Pulmonary,Pressure, Wedge,Pressures, Wedge,Wedge Pressures
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D002302 Cardiac Output The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat). Cardiac Outputs,Output, Cardiac,Outputs, Cardiac
D005466 Fluorocarbons Liquid perfluorinated carbon compounds which may or may not contain a hetero atom such as nitrogen, oxygen or sulfur, but do not contain another halogen or hydrogen atom. This concept includes fluorocarbon emulsions, and fluorocarbon blood substitutes. Perfluorinated and related polyfluorinated chemicals are referred to as PFAS and are defined as chemicals with at least two adjacent carbon atoms, where one carbon is fully fluorinated and the other is at least partially fluorinated. Fluorocarbon,Fluorocarbon Emulsion,Fluorocarbon Emulsions,Fluorotelomer Phosphate Esters,N-Alkyl Perfluoroalkyl Sulfonamido Carboxylates,PFAS Per- and Polyfluoroalkyl Substances,PFC Perfluorinated Chemicals,PFECAs Perfluoropolyether Carboxylic Acids,Per- and Polyfluoroalkyl Substances,Perfluoroalkane Sulfonamides,Perfluoroalkyl Carboxylates,Perfluoroalkyl Ether Carboxylates,Perfluoroalkyl Polyether Carboxylates,Perfluorocarbon,Perfluorocarbons,Perfluoropolyether Carboxylic Acids,Polyfluorocarbons,Fluorinated Telomer Alcohols,Fluoro-Telomer Alcohols,Polyfluorinated Telomer Alcohols,Telomer Fluorocarbons,Acids, Perfluoropolyether Carboxylic,Alcohols, Fluorinated Telomer,Alcohols, Fluoro-Telomer,Alcohols, Polyfluorinated Telomer,Carboxylates, Perfluoroalkyl,Carboxylates, Perfluoroalkyl Ether,Carboxylates, Perfluoroalkyl Polyether,Carboxylic Acids, Perfluoropolyether,Chemicals, PFC Perfluorinated,Emulsion, Fluorocarbon,Emulsions, Fluorocarbon,Esters, Fluorotelomer Phosphate,Ether Carboxylates, Perfluoroalkyl,Fluoro Telomer Alcohols,Fluorocarbons, Telomer,N Alkyl Perfluoroalkyl Sulfonamido Carboxylates,PFAS Per and Polyfluoroalkyl Substances,Per and Polyfluoroalkyl Substances,Perfluorinated Chemicals, PFC,Phosphate Esters, Fluorotelomer,Polyether Carboxylates, Perfluoroalkyl,Sulfonamides, Perfluoroalkane,Telomer Alcohols, Fluorinated,Telomer Alcohols, Polyfluorinated
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006842 Hydrocarbons, Brominated Hydrocarbon compounds with one or more HYDROGEN atoms substituted with BROMINE. Brominated Hydrocarbons
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D012756 Sheep Any of the ruminant mammals with curved horns in the genus Ovis, family Bovidae. They possess lachrymal grooves and interdigital glands, which are absent in GOATS. Ovis,Sheep, Dall,Dall Sheep,Ovis dalli

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