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Tissue Oxygen Available (O2a) as a Criterion for the Effectiveness of Continuous Positive Pressure Breathing (CPPB)

  • Anthony V. Beran
  • Donald R. Sperling
  • Kenneth G. Proctor
  • Robert F. Huxtable
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 75)

Abstract

Since Gregory’s report (I) on the effectiveness of Continuous Positive Airway Pressure for treatment of infants with the Idiopathic Respiratory Distress Syndrome (IRDS), the method has been widely accepted throughout the world. This method provides increased proximal airway pressure (Ppa) sufficient to prevent alveolar collapse at the end of expiration, while the subject is breathing spontaneously. In the normal lung, as little as 3–5 cm H2O Ppa may reduce cardiac output (Q̇). Contrary to this, it is postulated that in IRDS, decreased pulmonary compliance (SCL) acts as a barrier and minimizes this effect. Pulmonary compliance varies widely between normal subjects and those with IRDS of varying severity. Therefore, a wide range of Ppa is required to provide optimal oxygenation without reducing Q̇. Since Q̇ is not routinely measured, a reduction in Q̇ could follow an excessive increase in Ppa; in addition, excessive reduction in Q̇ could accompany regression of the disease while Ppa is unchanged.

Keywords

Continuous Positive Airway Pressure Normal Lung Damage Lung Normal Compl Iance Pulmonary Compl Iance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

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    Gregory GA, Kitterman JA, Phibbs RH, Tooley WH and Hamilton WK. Treatment of the idiopathic respiratory distress syndrome with continuous positive airway pressure. New Eng J Med 284:1535, 1971.CrossRefGoogle Scholar
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    Gribetz I, Frank NR and Avery ME. Static volume pressure relations of excised lungs of infants with hyaline membrane disease, newborn and stillborn infants. J Clin Invest 58:2168, 1959.CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1976

Authors and Affiliations

  • Anthony V. Beran
    • 1
    • 2
  • Donald R. Sperling
    • 1
    • 2
  • Kenneth G. Proctor
    • 1
    • 2
  • Robert F. Huxtable
    • 1
    • 2
  1. 1.College of MedicineUniversity of CaliforniaIrvineUSA
  2. 2.Department of PediatricsIrvineUSA

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