Oj. Veddeng et al., SELECTIVE POSITIVE END-EXPIRATORY PRESSURE AND RIGHT-VENTRICULAR FUNCTION IN DOGS, Acta anaesthesiologica Scandinavica, 38(2), 1994, pp. 175-179
Differential ventilation with selective positive end-expiratory pressu
re (PEEP) has been shown to reduce cardiac output less than general PE
EP. In previous studies we have demonstrated that during selective PEE
P left ventricular preload is better maintained than during general PE
EP. The present study was designed to determine whether the different
haemodynamic responses to selective and general PEEP also might be due
to different effects on RV preload. The study was performed on nine a
cutely instrumented dogs, in which extraventricular pressure was measu
red by pericardial balloon transducers. Measures of RV preload were ob
tained by the use of ultrasonic segment length transducers as well as
end-diastolic transmural pressure (RVEDP(TM)). The study showed reduct
ions in RVEDP(TM) during general and selective right (R) PEEP, accompa
nied by moderate reductions in RV inflow tract segment lengths. These
changes were most marked with general PEEP. Selective LPEEP did not ch
ange RV preload significantly Therefore, better maintained cardiac out
put with selective PEEP than with general PEEP is partly due to less i
mpairment of right ventricular filling.