Reduction in pulmonary blood volume during positive end-expiratory pressure. 1983

R A Slutsky

The response of intravascular (PBV) and extravascular (EVLW) pulmonary fluid volumes to varying degrees of positive end-expiratory pressure (PEEP) was examined using double indicator techniques (thermal green dye) in six open-chest anesthetized dogs during the production of oleic acid (0.15 cc/kg)-induced pulmonary injury. Data were obtained at a control state, then 1.5 hr after the oleic acid was injected. Positive-end expiratory pressure (5, 10, 15, and 20 cm H2O) consistently reduced cardiac output prior to and after oleic acid edema was created, with greater reductions occurring with higher levels of PEEP. Increasing amounts of PEEP consistently produced greater reductions in PBV (with and without pulmonary edema), though without significant effect on EVLW. PBV declined from 6.0 +/- 2.4 to 4.0 +/- 1.0 ml/kg with 20 cm H2O of PEEP (P less than .01) in the control state and 4.4 +/- 2.1 to 2.9 +/0 0.9 ml/kg (P less than .01) after oleic acid administration. It is concluded that PEEP significantly reduced intravascular pulmonary fluid volumes along with cardiac output, without changing EVLW. While the effects of altered left ventricular geometry were not examined, the displacement of blood from the central to the peripheral circulation during PEEP must substantially contribute to reductions in systemic flow.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D009829 Oleic Acids A group of fatty acids that contain 18 carbon atoms and a double bond at the omega 9 carbon. Octadecenoic Acids,Acids, Octadecenoic,Acids, Oleic
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
D011654 Pulmonary Edema Excessive accumulation of extravascular fluid in the lung, an indication of a serious underlying disease or disorder. Pulmonary edema prevents efficient PULMONARY GAS EXCHANGE in the PULMONARY ALVEOLI, and can be life-threatening. Wet Lung,Edema, Pulmonary,Edemas, Pulmonary,Pulmonary Edemas,Lung, Wet,Lungs, Wet,Wet Lungs
D001810 Blood Volume Volume of circulating BLOOD. It is the sum of the PLASMA VOLUME and ERYTHROCYTE VOLUME. Blood Volumes,Volume, Blood,Volumes, Blood
D001834 Body Water Fluids composed mainly of water found within the body. Water, Body
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
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
D019301 Oleic Acid An unsaturated fatty acid that is the most widely distributed and abundant fatty acid in nature. It is used commercially in the preparation of oleates and lotions, and as a pharmaceutical solvent. (Stedman, 26th ed) 9-Octadecenoic Acid,Oleate,cis-9-Octadecenoic Acid,9 Octadecenoic Acid,cis 9 Octadecenoic Acid

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