-transparent.png){kind=logo}
The effects of incremental increases in PEEP during mechanical ventilation on left ventricular (LV) contractility before and after intravascular volume expansion (IVE) were studied in 10 patients treated for ARDS. A pulmonary artery (PA) catheter, a LV catheter-tip micromanometer, and an esophageal balloon catheter were inserted in these patients. We measured transmural right atrial and PA pressures, transmural LV end-diastolic and systemic arterial pressures, the first derivative of LV pressure (LV dP/dt), the ratio of LV dP/dt at transmural developed LV pressure (dP/dt/DPt) with DPt = 5, 10, 40 mm Hg, cardiac index (CI) at every level of PEEP and after IVE at the highest PEEP. Stepwise increases in PEEP (from 0-20 cm H2O) were associated with progressive fall in CI whereas heart rate remained unchanged. Transmural right atrial and PA pressures did not change; transmural LV end-diastolic and systemic arterial pressures and peak dP/dt decreased significantly with PEEP, except for dT/dt/dPt. IVE reversed this fall in CI and peak dP/dt. Whereas transmural LV end-diastolic pressure rose markedly. We conclude that the observed fall in LV performance during PEEP is not the result of a depressed LV contractility because PEEP does not induce a decrease in dP/dt/DPt, the least sensitive to change in preload isovolumic phase indices of contractility.
J F Dhainaut, and
C Bricard, and
F J Monsallier, and
O Salmon, and
J Bons, and
V Fourestie, and
B Schlemmer, and
A Carli
January 1975,
Cardiovascular diseases,
J F Dhainaut, and
C Bricard, and
F J Monsallier, and
O Salmon, and
J Bons, and
V Fourestie, and
B Schlemmer, and
A Carli
August 1981,
Herz,
J F Dhainaut, and
C Bricard, and
F J Monsallier, and
O Salmon, and
J Bons, and
V Fourestie, and
B Schlemmer, and
A Carli
May 1976,
American heart journal,
J F Dhainaut, and
C Bricard, and
F J Monsallier, and
O Salmon, and
J Bons, and
V Fourestie, and
B Schlemmer, and
A Carli
July 1981,
Cardiovascular research,
J F Dhainaut, and
C Bricard, and
F J Monsallier, and
O Salmon, and
J Bons, and
V Fourestie, and
B Schlemmer, and
A Carli
March 1983,
British heart journal,
J F Dhainaut, and
C Bricard, and
F J Monsallier, and
O Salmon, and
J Bons, and
V Fourestie, and
B Schlemmer, and
A Carli
December 2005,
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography,
J F Dhainaut, and
C Bricard, and
F J Monsallier, and
O Salmon, and
J Bons, and
V Fourestie, and
B Schlemmer, and
A Carli
January 1980,
Cardiology,
J F Dhainaut, and
C Bricard, and
F J Monsallier, and
O Salmon, and
J Bons, and
V Fourestie, and
B Schlemmer, and
A Carli
December 1981,
Zeitschrift fur Kardiologie,
J F Dhainaut, and
C Bricard, and
F J Monsallier, and
O Salmon, and
J Bons, and
V Fourestie, and
B Schlemmer, and
A Carli
January 1990,
Progress in cardiovascular diseases,
J F Dhainaut, and
C Bricard, and
F J Monsallier, and
O Salmon, and
J Bons, and
V Fourestie, and
B Schlemmer, and
A Carli
September 1973,
Circulation,
