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Haemodynamic and volumetric response to tidal volume and positive end expiratory pressure variation in acute lung injury/acute respiratory distress syndrome patients
Critical Care volume 8, Article number: P45 (2004)
Aim of study
To evaluate (1) the haemodynamic and volumetric response to incremental changes of tidal volume and (2) the haemodynamic and volumetric response to incremental changes of PEEP.
Materials and methods
Twenty acute lung injury (ALI)/ARDS patients were mechanically ventilated and connected to an integrated monitoring system (PICCO system; Agilent) by a fiberoptic arterial catheter (pv 2014L16) and a central venous catheter. All patients were randomised to receive mechanical ventilation with an incremental tidal volume (TV) (6, 8, 10 and 12 ml/kg at ZEEP) (group A) or TV = 6 ml/kg and incremental PEEP (5, 10 and 15 cmH2O) (group B). At every change of respiratory parameters the main haemodynamic and volumetric data were evaluated. Cardiac output (CO) was evaluated continuously online. All data are expressed as the mean ± SD. The ANOVA test was used to compare changes at different TV and at incremental levels of PEEP. P < 0.05 was considered statistically significant.
TV ≥ 10 ml/kg decreases either the CO or the mean arterial pressure (MAP). (2) PEEP 15 ≥ cmH2O decreases CO. (3) Mechanical ventilation with TV ≤ 6 ml/kg and PEEP 10 ≤ cmH2O has minimal impact on the cardiovascular system. (4) Optimisation of ITBVI may improve the cardiovascular response to mechanical ventilation adjustment.
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Turani, F., Curatola, D. & Santoro, G. Haemodynamic and volumetric response to tidal volume and positive end expiratory pressure variation in acute lung injury/acute respiratory distress syndrome patients. Crit Care 8, P45 (2004). https://doi.org/10.1186/cc2512
- Cardiac Output
- Mechanical Ventilation
- Tidal Volume
- Mean Arterial Pressure
- Acute Lung Injury