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Ann Thorac Surg 1977;23:555-559
© 1977 The Society of Thoracic Surgeons

Articles

Effects of PEEP on Cardiovascular Dynamics after Open-Heart Surgery: A New Postoperative Monitoring Technique

Thomas A. Angerpointner, M.D., Alan E. Farnsworth, F.R.C.S., Bryn T. Williams, F.R.C.S.*

From the Department of Cardiothoracic Surgery, St Thomas Hospital, Lambeth Palace Rd, London, England

Accepted for publication December 1, 1976.

* Address reprint requests to Mr. Williams, Department of Cardiothoracic Surgery, St Thomas' Hospital, London, SE1 7EH, England

The circulatory effects of incremental increases in positive end-expiratory pressure ventilation (PEEP) were assessed on 11 occasions in postoperative cardiac surgical patients by phasic aortic blood flow measurements and high-fidelity pressure recordings from which flow and pressure-flow derivatives of cardiac performance were calculated. At 15 cm H2O PEEP, mean arterial blood pressure was decreased by 10%, stroke volume and cardiac output by 15%, and peak left ventricular power by 21%. Although these indices promptly returned to control levels when PEEP was discontinued, levels of PEEP above 10 cm H2O should be used with caution for this group of patients.




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