Cardiac function and haemodynamics during transition to high-frequency oscillatory ventilation.
Eur J Anaesthesiol
; 21(12): 944-52, 2004 Dec.
Article
em En
| MEDLINE
| ID: mdl-15719857
ABSTRACT
BACKGROUND AND OBJECTIVE:
This prospective observational study analyses cardiovascular changes in adult patients with acute respiratory distress syndrome (ARDS) during transition from pressure-controlled ventilation to high-frequency oscillatory ventilation (HFOV), using transoesophageal echocardiography (TOE) and invasive haemodynamic monitoring.METHODS:
Nine patients (median age 65 years; range 42-70) with ARDS were studied. HFOV was started and maintained with an adjusted mean airway pressure of 5 cmH2O above the last measured mean airway pressure during pressure-controlled ventilation. Haemodynamic and TOE measurements were performed in end-expiration during baseline pressure-controlled ventilation, and again 5 and 30 min after the start of during uninterrupted HFOV.RESULTS:
Right atrial pressure increased immediately (P = 0.004). After 30 min, pulmonary arterial occlusion pressure increased (P = 0.008), cardiac index decreased (P = 0.01), stroke volume index decreased (P = 0.02) and both left ventricular end-diastolic and end-systolic area indices decreased (P = 0.02). Fractional area change, left ventricular end-systolic wall stress, heart rate, mean arterial pressure and mean pulmonary artery pressure remained unchanged.CONCLUSIONS:
Transition to HFOV at a mean airway pressure of 5 cmH2O above that during pressure-controlled ventilation induced significant, but clinically minor, haemodynamic effects, which are most probably due to airway pressure-related preload reduction.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome do Desconforto Respiratório
/
Ventilação de Alta Frequência
/
Coração
/
Testes de Função Cardíaca
/
Hemodinâmica
Tipo de estudo:
Observational_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article