Indian Journal of Critical Care Medicine
An open access publication of ISCCM™ 
 
Users online: 54 
     Home | Login 
  About Current Issue Archive Search Instructions Online Submission Subscribe Etcetera Contact  
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2989    
    Printed163    
    Emailed3    
    PDF Downloaded398    
    Comments [Add]    
    Cited by others 1    

Recommend this journal

 

 RESEARCH ARTICLE
Year : 2009  |  Volume : 13  |  Issue : 1  |  Page : 12--16

Changes of splanchnic perfusion after applying positive end expiratory pressure in patients with acute respiratory distress syndrome


Department of Anesthesiology, Intensive Care Unit, IMS Banaras Hindu University, Varanasi-221 105, Uttar Pradesh, India

Correspondence Address:
Suman Sarkar
Department of Anesthesiology and Critical Care, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221 005, Uttar Pradesh
India
Login to access the Email id


DOI: 10.4103/0972-5229.53109

PMID: 19881173

Get Permissions

Read associated Retraction Notice: Retraction Notice with this article

Background: Positive end-expiratory pressure (PEEP) improves oxygenation and can prevent ventilator- induced lung injury in patients with acute respiratory distress syndrome (ARDS). Nevertheless, PEEP can also induce detrimental effects by its influence on the cardiovascular system. The purpose of this study was to assess the effects of PEEP on gastric mucosal perfusion while applying a protective ventilatory strategy in patients with ARDS. Materials and Methods: Thirty-two patients were included in the study. A pressure-volume curve was traced and ideal PEEP, defined as lower inflection point + 2cmH 2 O, was determined. Gastric tonometry was measured continuously (Tonocap). After baseline measurements, 10, 15 and 20cmH 2 O PEEP and ideal PEEP were applied for 30 min each. By the end of each period, hemodynamics, CO 2 gap (gastric minus arterial partial pressures), and ventilatory measurements were taken. Results: PEEP had no effect on CO 2 gap (median [range], baseline: 18 [2-30] mmHg; PEEP 10: 18 [0-40] mmHg; PEEP 15: 17 [0-39] mmHg; PEEP 20: 16 [4-39] mmHg; ideal PEEP: 19 [9-39] mmHg; P = 0.19). Cardiac index also remained unchanged (baseline: 4.7 [2.6-6.2] l min−1 m−2 ; PEEP 10: 4.4 [2.5-7] l min−1 m−2 ; PEEP 15: 4.4 [2.2-6.8] l min−1 m−2 ; PEEP 20: 4.8 [2.4-6.3] l min−1 m−2 ; ideal PEEP: 4.9 [2.4-6.3] l min−1 m−2 ; P = 0.09). Conclusion: PEEP of 10-20 cmH 2 O does not affect splanchnic perfusion and is hemodynamically well tolerated in most patients with ARDS, including those receiving inotropic supports.






[FULL TEXT] [PDF Not available]*


        
Print this article     Email this article

Online since 7th April '04
Published by Medknow