Effect of Different Respirator Adjustments on Central Haemodynamics in Open-Heart Surgery Patients
| Autor: | J. K. Irjala, Laaksonen Vo, Inberg Mv, Arola Mk, A. V. Kari |
|---|---|
| Rok vydání: | 1977 |
| Předmět: |
Adult
Male Pulmonary Circulation medicine.medical_specialty Cardiac output Central Venous Pressure Cardiac index Hemodynamics Blood Pressure Aortic valve replacement medicine.artery Myocardial Revascularization medicine Humans Cardiac Output Cardiac Surgical Procedures Pulmonary wedge pressure Intermittent Positive-Pressure Breathing Ventilators Mechanical business.industry Respiration Central venous pressure General Medicine Middle Aged medicine.disease Respiration Artificial Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Aortic Valve Anesthesia Pulmonary artery Vascular resistance Female Vascular Resistance business |
| Zdroj: | Acta Anaesthesiologica Scandinavica. 21:200-210 |
| ISSN: | 1399-6576 0001-5172 |
| DOI: | 10.1111/j.1399-6576.1977.tb01210.x |
| Popis: | Changes in cardiac index (CI), mean pulmonary artery pressure (PAP), mean pulmonary capillary wedge pressure (PCWP), central venous pressure (CVP), and pulmonary artery vascular resistance (PVR), associated with spontaneous respiration (SR) and two different types of intermittent positive pressure ventilation (IPPPV and IPNPV) were studied in a total of 17 patients undergoing aortic valve replacement or myocardial revascularization. Swan-Ganz thermodilution pulmonary artery cardiac output catheters were used and the aim was to determine: whether postoperative cardiac output may paradoxically be greater during IPPPV than during IPNPV or SR; whether the use of “negative” pressure in the expiratory phase during controlled ventilation may be responsible for bringing about the central haemodynamic conditions prevailing during spontaneous respiration; and whether, in weaning from postoperative IPPPV to SR, there is a risk of pulmonary congestion as a consequence of possible autotransfusion. IPPPV connected with anaesthesia induction caused a highly significant deterioration of central haemodynamics. The use of positive end-expiratory pressure (PEEP) is not to be recommended for such patients at this stage. On the first postoperative day, the mean CI was lower during IPPPV than during IPNPV (P |
| Databáze: | OpenAIRE |
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