Effects of positive end-expiratory pressure on gastric mucosal perfusion in acute respiratory distress syndrome

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dc.contributor.authorBruhn, Alejandro
dc.contributor.authorHernández P., Glenn
dc.contributor.authorBugedo Tarraza, Guillermo
dc.contributor.authorCastillo Fuenzalida, Luis
dc.date.accessioned2019-10-17T13:20:12Z
dc.date.available2019-10-17T13:20:12Z
dc.date.issued2004
dc.date.updated2019-10-14T19:04:08Z
dc.description.abstractAbstract Introduction 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. Methods Eight patients were included. A pressure–volume curve was traced and ideal PEEP, defined as lower inflection point + 2 cmH2O, was determined. Gastric tonometry was measured continuously (Tonocap). After baseline measurements, 10, 15 and 20 cmH2O PEEP and ideal PEEP were applied for 30 min each. By the end of each period, hemodynamic, CO2 gap (gastric minus arterial partial pressures), and ventilatory measurements were performed. Results PEEP had no effect on CO2 gap (median [range], baseline: 19 [2–30] mmHg; PEEP 10: 19 [0–40] mmHg; PEEP 15: 18 [0–39] mmHg; PEEP 20: 17 [4–39] mmHg; ideal PEEP: 19 [9–39] mmHg; P = 0.18). Cardiac index also remained unchanged (baseline: 4.6 [2.5–6.3] l min-1 m-2; PEEP 10: 4.5 [2.5–6.9] l min-1 m-2; PEEP 15: 4.3 [2–6.8] l min-1 m-2; PEEP 20: 4.7 [2.4–6.2] l min-1 m-2; ideal PEEP: 5.1 [2.1–6.3] l min-1 m-2; P = 0.08). One patient did not complete the protocol because of hypotension. Conclusion PEEP of 10–20 cmH2O does not affect gastric mucosal perfusion and is hemodynamically well tolerated in most patients with ARDS, including those receiving adrenergic drugs.
dc.fuente.origenBiomed Central
dc.identifier.citationCritical Care. 2004 Jul 15;8(5):R306
dc.identifier.doi10.1186/cc2905
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/26619
dc.identifier.wosidWOS:000225003800031
dc.issue.numeroNo. 5
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final311
dc.pagina.inicio306
dc.revistaOpen Accesses_ES
dc.rightsacceso abierto
dc.rights.holderBruhn et al.; licensee BioMed Central Ltd.
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.subject.otherSíndrome de dificultad respiratoria agudaes_ES
dc.subject.otherMucosa gástricaes_ES
dc.subject.otherPulmones -Lesioneses_ES
dc.subject.otherVentiladores pulmonareses_ES
dc.titleEffects of positive end-expiratory pressure on gastric mucosal perfusion in acute respiratory distress syndromees_ES
dc.typeartículo
dc.volumenVol. 8
sipa.codpersvinculados741
sipa.codpersvinculados98874
sipa.codpersvinculados103776
sipa.codpersvinculados54397
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