Comparative hemodynamic consequences of inflation hold, PEEP, and interrupted PEEP: an experimental study in normal dogs.
Cardiac output and airway, intrathoracic, arterial, pulmonary artery, left atrial, and central venous pressures were studied in 8 mongrel dogs. They were anesthetized and ventilated with (1) inflation hold of various duration, (2) continuous positive end-expiratory pressure and one breath off). The results indicate a minimal decrease in cardiac output (of approximately 5 per cent) with inflation hold. Diminished cardiac output was noted with increasing levels of continuous PEEP. The severity of the decrease in cardiac output wasproportional to the airway pressure. The higher levels (20 cm H2O) OF PEEP were associated with profound decreases. Utilization of a technique of interrupted PEEP substantially reduced the adverse hemodynamic effects in the dog.