Summary
The effect of a positive expiratory pressure plateau (pepp) on gas exchange, cardiac output, and frc is examined in five patients in severe respiratory failure receiving artificial ventilation. Improvement in gas exchange for both oxygen and carbon dioxide without change in cardiac output is demonstrated in all cases. This is associated with an increase in resting lung volume. The mechanisms and therapeutic implication of these changes are discussed. It is suggested that this feature of the ventilatory wave form may be of considerable value in the management of severe hypoxia during respiratory failure.
Résumé
Chez cinq malades souffrant de défaillance respiratoire grave recevant une ventilation artificielle, nous avons étudié ľeffet ďun plateau de pression positive à ľexpiration (pepp) sur les échanges gazeux, le débit cardiaque et la frC. Dans tous les cas, nous avons pu démontrer une amélioration des échanges gazeux et pour ľoxygène et pour le gaz carbonique sans modification du débit cardiaque. Cela s’est accompagné ďune augmentation du volume pulmonaire au repos. Nous avons discuté les mécanismes et ľimplication thérapeutique de ces modifications. Il est possible que ce facteur dans la forme du tracé ou de ľonde respiratoire puisse être de grande valeur dans le traitement de ľhypoxie prononcée au cours de la défaillance respiratoire.
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Presented at the Annual Meeting, Canadian Anaesthetists’ Society, Toronto, June 17, 1969.
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McIntyre, R.W., Laws, A.K. & Ramachandran, P.R. Positive expiratory pressure plateau: improved gas exchange during mechanical ventilation. Can. Anaes. Soc. J. 16, 477–486 (1969). https://doi.org/10.1007/BF03004541
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DOI: https://doi.org/10.1007/BF03004541