Net A, Vazquez G, Benito S, Artigas A, Martinez R, Quintana M I
Anesth Analg (Paris). 1981;38(11-12):613-5.
According to Powers et collaborators the hypothesis that intramyocardial vessels may be collapsed in artificially ventilated patient with added PEEP, could be arisen. So, myocardial ischemia may explain why in some of those ones there appear signs of left ventricular failure. To test whether this reasoning was correct we measured LVEDP in normal dogs submitted to increasing levels of PEEP up to 40 cm H2O. Our results seem to point towards the following conclusions: a) In normal dogs, Starling relation is not altered and remains within the same hypercontractility pattern. b) As PEEP increases, ventricular function remains within the same curve up to 30 cm H2O and jumps to a higher contractility curve at 40 cm H2O of PEEP. All of this would suggest that under our experimental conditions it does not seem reasonable to assume the existence of left ventricular failure due to PEEP influence.
据鲍尔斯及其合作者称,在接受呼气末正压通气(PEEP)的人工通气患者中,可能会出现心肌内血管塌陷的假说。因此,心肌缺血可能解释了为什么其中一些患者会出现左心室衰竭的迹象。为了验证这一推理是否正确,我们对正常犬施加高达40 cm H₂O的递增水平PEEP,并测量其左心室舒张末期压力(LVEDP)。我们的结果似乎指向以下结论:a)在正常犬中,斯塔林关系未改变,仍处于相同的高收缩模式内。b)随着PEEP增加,心室功能在高达30 cm H₂O时保持在同一条曲线上,而在40 cm H₂O的PEEP时跃升至更高的收缩曲线。所有这些都表明,在我们的实验条件下,假设由于PEEP影响而存在左心室衰竭似乎不合理。