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Effects of positive end-expiratory pressure on the canine venous return curve.
Am Rev Respir Dis. 1992 Jul; 146(1):4-10.AR

Abstract

To study the mechanism whereby positive end-expiratory pressure (PEEP) decreases venous return, we used a closed-chest canine venous bypass preparation to study the effects of 10 mm Hg PEEP on the systemic venous pressure-flow curves from the superior and inferior vena cava (SVC and IVC). These curves were characterized by three variables: the critical downstream pressure below which venous return was maximal (PCRIT), the conductance to venous return (GVR), and the effective upstream pressure driving venous return. PEEP reduced venous return by decreasing the maximal venous return even when the pressures at the outflow of the IVC and SVC were maintained below zero. PEEP increased PCRIT in the SVC and IVC (SVC: -0.31 +/- 0.53 to 3.21 +/- 0.84; IVC: -0.41 +/- 0.64 to 5.23 +/- 1.02 (SE) mm Hg; p less than 0.005). GVR in the SVC was reduced (52.5 +/- 26 to 37.8 +/- 5.3 (SE) ml/min/mm Hg; p less than 0.005), but changes in the IVC did not reach statistical significance. These changes were partially offset by increases in the upstream pressure driving venous return (SVC: 9.44 +/- 0.54 to 12.25 +/- 0.71; IVC: 9.42 +/- 0.69 to 12.51 +/- 1.02 (SE) mm Hg; p less than 0.01). Analysis of these findings suggests that PEEP may alter venous return through effects on the peripheral circulation, independent of its effects on the heart.

Authors+Show Affiliations

Department of Medicine, Johns Hopkins Asthma and Allergy Center, Baltimore, Maryland 21224.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

1626812

Citation

Fessler, H E., et al. "Effects of Positive End-expiratory Pressure On the Canine Venous Return Curve." The American Review of Respiratory Disease, vol. 146, no. 1, 1992, pp. 4-10.
Fessler HE, Brower RG, Wise RA, et al. Effects of positive end-expiratory pressure on the canine venous return curve. Am Rev Respir Dis. 1992;146(1):4-10.
Fessler, H. E., Brower, R. G., Wise, R. A., & Permutt, S. (1992). Effects of positive end-expiratory pressure on the canine venous return curve. The American Review of Respiratory Disease, 146(1), 4-10.
Fessler HE, et al. Effects of Positive End-expiratory Pressure On the Canine Venous Return Curve. Am Rev Respir Dis. 1992;146(1):4-10. PubMed PMID: 1626812.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of positive end-expiratory pressure on the canine venous return curve. AU - Fessler,H E, AU - Brower,R G, AU - Wise,R A, AU - Permutt,S, PY - 1992/7/1/pubmed PY - 1992/7/1/medline PY - 1992/7/1/entrez SP - 4 EP - 10 JF - The American review of respiratory disease JO - Am Rev Respir Dis VL - 146 IS - 1 N2 - To study the mechanism whereby positive end-expiratory pressure (PEEP) decreases venous return, we used a closed-chest canine venous bypass preparation to study the effects of 10 mm Hg PEEP on the systemic venous pressure-flow curves from the superior and inferior vena cava (SVC and IVC). These curves were characterized by three variables: the critical downstream pressure below which venous return was maximal (PCRIT), the conductance to venous return (GVR), and the effective upstream pressure driving venous return. PEEP reduced venous return by decreasing the maximal venous return even when the pressures at the outflow of the IVC and SVC were maintained below zero. PEEP increased PCRIT in the SVC and IVC (SVC: -0.31 +/- 0.53 to 3.21 +/- 0.84; IVC: -0.41 +/- 0.64 to 5.23 +/- 1.02 (SE) mm Hg; p less than 0.005). GVR in the SVC was reduced (52.5 +/- 26 to 37.8 +/- 5.3 (SE) ml/min/mm Hg; p less than 0.005), but changes in the IVC did not reach statistical significance. These changes were partially offset by increases in the upstream pressure driving venous return (SVC: 9.44 +/- 0.54 to 12.25 +/- 0.71; IVC: 9.42 +/- 0.69 to 12.51 +/- 1.02 (SE) mm Hg; p less than 0.01). Analysis of these findings suggests that PEEP may alter venous return through effects on the peripheral circulation, independent of its effects on the heart. SN - 0003-0805 UR - https://www.unboundmedicine.com/medline/citation/1626812/Effects_of_positive_end_expiratory_pressure_on_the_canine_venous_return_curve_ L2 - https://www.atsjournals.org/doi/10.1164/ajrccm/146.1.4?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -