Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
EFFECTS OF MECHANICAL VENTILATION WITH PEEP ON RIGHT-TO-LEFT INTRACARDIAC SHUNTING FROM A PATENT FORAMEN OVALE
Autore:
VEDRINNE JM; DUPERRET S; GRATADOUR P; BARTHELEMY C; MOTIN J;
Indirizzi:
HOP EDOUARD HERRIOT,SERV REANIMAT,PAVILLON G F-69437 LYON 03 FRANCE
Titolo Testata:
Annales francaises d'anesthesie et de reanimation
fascicolo: 5, volume: 14, anno: 1995,
pagine: 387 - 392
SICI:
0750-7658(1995)14:5<387:EOMVWP>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Keywords:
ECHOCARDIOGRAPHY; HYPOXEMIA; PATENT FORAMEN OVALE; MECHANICAL VENTILATION; POSITIVE END EXPIRATORY PRESSURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
NO
Recensione:
Indirizzi per estratti:
Citazione:
J.M. Vedrinne et al., "EFFECTS OF MECHANICAL VENTILATION WITH PEEP ON RIGHT-TO-LEFT INTRACARDIAC SHUNTING FROM A PATENT FORAMEN OVALE", Annales francaises d'anesthesie et de reanimation, 14(5), 1995, pp. 387-392

Abstract

Objective: To assess the presence of a patent foramen ovale (PFO) using colloid contrast transoesophageal echocardiography in mechanically ventilated patient with and without PEEP and it repercussion on PaO2. Study design: Prospective open before-after trial. Patients: Forty-nine mechanically ventilated patients with respiratory failure (PaO2/FiO(2) < 250). Methods: PEEP assessment before and after adding a PEEP = 10 cmH(2)O. At each level of PEEP, semi-quantification of PFO was performed and arterial blood gases were withdrawn at FiO(2) = 1, with 15 min at each level. Semiquantification of the right-to-left intra cardiacshunt through a patent foramen ovale was obtained using the quantity of microbubbles in the left atrium on a basal short axis view. Results: A PFO was detected in 11 out of 49 patients (22%). A right-to-left shunt developed in one and worsen in three patients when PEEP was added. In patients without a PFO, PaO2 increased significantly (from 119 +/- 10 mmHg to 145 +/- 10 mmHg, P < 0.001). In patients with a PFO, non significant changes occurred (118 +/- 15 mmHg to 120 +/- 17 mmHg). After adding PEEP, the difference between the two groups was significant (ANOVA, P < 0.05). Moreover, a PFO was present during the whole respiratory cycle in two out of 11 patients. These 2 patients exhibited a PaO2 < 100 mmHg with or without PEEP. Conclusion: This study suggests that mechanical ventilation with PEEP enhances an intracardiac right-to-left shunt through a PFO. This condition is responsible for the lack of improvement in blood oxygenation when PEEP is added. When a PFO is present all over the respiratory cycle, or when the oxygenation is worsened with PEEP, this positive pressure ventilation should be avoided. The deleterious consequences of mechanical ventilation on venous return may be minimized by partial ventilation and weaning from ventilator.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/20 alle ore 23:06:02