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Ann Thorac Surg 1975;19:552-560
© 1975 The Society of Thoracic Surgeons

Articles

Comparative Hemodynamic Consequences of Inflation Hold, PEEP, and Interrupted PEEP: An Experimental Study in Normal Dogs

Kenneth F. MacDonnell, M.D.*, Armand A. Lefemine, M.D., Hyung S. Moon, M.D., Daniel J. Donovan, A.B., Richard P. Johnston

Pulmonary and Respiratory Units and the Department of Cardio-Thoracic Surgery, St. Elizabeth's Hospital of Boston, Brighton, and the Departments of Medicine and Surgery, Tufts University School of Medicine, Boston, Mass

Accepted for publication November 26, 1974.

* Address reprint requests to Dr. MacDonnell, Pulmonary Unit, St. Elizabeth's Hospital, 736 Cambridge St., Brighton, Mass. 02135

Cardiac output and airway, intrathoracic, arterial, pulmonary artery, left atrial, and central venous pressures were studied in 8 mongrel dogs. They were anesthetized and ventilated with (1) inflation hold of various duration, (2) continuous positive end-expiratory pressure (PEEP), and (3) interrupted PEEP (three breaths on positive end-expiratory pressure and one breath off).

The results indicate a minimal decrease in cardiac output (of approximately 5%) with inflation hold. Diminished cardiac output was noted with increasing levels of continuous PEEP. The severity of the decrease in cardiac output was proportional to the airway pressure. The higher levels (20 cm H2O) of PEEP were associated with profound decreases. Utilization of a technique of interrupted PEEP substantially reduced the adverse hemodynamic effects in the dog.






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