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Titolo:
HEMODYNAMIC-EFFECTS OF PRESSURE SUPPORT AND PEEP VENTILATION BY NASALROUTE IN PATIENTS WITH STABLE CHRONIC OBSTRUCTIVE PULMONARY-DISEASE
Autore:
AMBROSINO N; NAVA S; TORBICKI A; RICCARDI G; FRACCHIA C; OPASICH C; RAMPULLA C;
Indirizzi:
CTR MED RIABILITAZ,DIV PNEUMOL I-27040 MONTESCANO ITALY FDN IRCCS,CTR CARE & RES PAVIA ITALY MED ACAD WARSAW,DEPT HYPERTENS & ANGIOL PL-02032 WARSAW POLAND
Titolo Testata:
Thorax
fascicolo: 5, volume: 48, anno: 1993,
pagine: 523 - 528
SICI:
0040-6376(1993)48:5<523:HOPSAP>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
END-EXPIRATORY PRESSURE; LEFT-VENTRICULAR PERFORMANCE; COPD;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
39
Recensione:
Indirizzi per estratti:
Citazione:
N. Ambrosino et al., "HEMODYNAMIC-EFFECTS OF PRESSURE SUPPORT AND PEEP VENTILATION BY NASALROUTE IN PATIENTS WITH STABLE CHRONIC OBSTRUCTIVE PULMONARY-DISEASE", Thorax, 48(5), 1993, pp. 523-528

Abstract

Background-Intermittent positive pressure ventilation applied througha nasal mask has been shown to be useful in the treatment of chronic respiratory insufficiency. Pressure support ventilation is an assistedmode of ventilation which is being increasingly used. Invasive ventilation with intermittent positive pressure, with or without positive end expiratory pressure (PEEP), has been found to affect venous return and cardiac output. This study evaluated the acute haemodynamic effectsof short sessions of pressure support ventilation by nasal mask, withand without the application of PEEP, in patients with severe stable chronic obstructive pulmonary disease and hypercapnia. Methods-Nine patients with severe stable chronic obstructive pulmonary disease performed sessions lasting 10 minutes each of pressure support ventilation bynasal mask while undergoing right heart catheterisation for clinical evaluation. In random order, four sessions of nasal pressure support ventilation were applied consisting of. (1) peak inspiratory pressure (PIP) 10 cm H2O, PEEP 0 cm H2O; (2) PIP 10 cm H2O, PEEP 5 cm H2O; (3) PIP 20 cm H2O, PEEP 0 cm H2O; (4) PIP 20 cm H2O, PEEP 5 cm H2O. Results-Significant increases in arterial oxygen tension (PaO2) and saturation (SaO2) and significant reductions in arterial carbon dioxide tension(PaCO2) and changes in pH were observed with a PIP of 20 cm H2O. Statistical analysis showed that the addition of 5 cm H2O PEEP did not further improve arterial blood gas tensions. Comparison of baseline values with measurements performed after 10 minutes of each session of ventilation showed that all modes of ventilation except PIP 10 cm H2O without PEEP induced a small but significant increase in pulmonary capillary wedge pressure. In comparison with baseline values, a significant decrease in cardiac output and oxygen delivery was induced only by the addition of PEEP to both levels of PIP. Conclusions-In patients with severe stable chronic obstructive pulmonary disease and hypercapnia, pressure support ventilation with the addition of PEEP delivered by nasal mask may have short term acute haemodynamic effects in reducing oxygen delivery in spite of adequate levels of SaO2.

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Documento generato il 12/07/20 alle ore 10:41:32